Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A95207 | CA |
Y | 207X00000X | Orthopaedic Surgeon | M-10494 | ID |
NPI | 1003029034 |
---|---|
Provider Name | Dr. Joseph Marshall Bowen |
First Address | Coeur D Alene, ID 83814-6051 |
Second Address | Post Falls, ID 83854-5217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 06/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
808321400 | (05) | ID |