Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 25MB10546800 | NJ |
Y | 208000000X | Pediatrician | 25MB10546800 | NJ |
NPI | 1003278482 |
---|---|
Provider Name | Morgan Bowling |
First Address | Newark, NJ 07112-2027 |
Second Address | Newark, NJ 07112-2027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 22/09/2021 |