Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 21343 | CO |
NPI | 1013076108 |
---|---|
Provider Name | Dr. William J Bowman |
First Address | Aurora, CO 80012-6165 |
Second Address | Denver, CO 80231-4531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 18/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01213438 | (05) | CO |
205119406 | TAXID (01) | |
840854490 | TAXID (01) | |
D17360 | (02) | CO |