Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 148977 | NY |
NPI | 1427040385 |
---|---|
Provider Name | Dr. Roger Bowers |
First Address | Liverpool, NY 13088-3589 |
Second Address | Utica, NY 13501-5930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 12/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00708250 | (05) | NY |
C26025 | (02) | NY |