Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | DR.0034286 | CO |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 34286 | CO |
NPI | 1023079035 |
---|---|
Provider Name | Greg Alan Bowman |
First Address | Denver, CO 80256-0825 |
Second Address | Pueblo, CO 81003-2757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 04/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01342864 | (05) | CO |
G04067 | (02) | CO |