Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 041519 | GA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 041519 | GA |
NPI | 1124036876 |
---|---|
Provider Name | Dr. Scott G Bowerman |
First Address | Rome, GA 30161-4999 |
Second Address | Rome, GA 30161-4999 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 15/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000702809J | (05) | GA |
000702809M | (05) | GA |
00702809G | (05) | GA |
G27169 | (02) | GA |