Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2837584 | SC |
N | 207Q00000X | Family Doctor | 37584 | SC |
NPI | 1366720369 |
---|---|
Provider Name | Rebecca J Bowers |
First Address | Greenville, SC 29615-5489 |
Second Address | Greenville, SC 29615-6206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2011 |
Last Update Date | 08/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
375846 | (05) | SC |