Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | 29971 | TN |
Y | 207R00000X | Internist | 29971 | TN |
Y | 111NI0900X | Internist | 29971 | TN |
NPI | 1083641252 |
---|---|
Provider Name | Marcia R Bowden |
First Address | Memphis, TN 38104-2508 |
Second Address | Memphis, TN 38104-2508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 21/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G75309 | (02) | TN |