Provider Demographics
NPI:1053486076
Name:BOWMAN, DAVID P (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:576 E HIGHWAY 138
Mailing Address - Street 2:SUITE 350
Mailing Address - City:STANSBURY PARK
Mailing Address - State:UT
Mailing Address - Zip Code:84074-4027
Mailing Address - Country:US
Mailing Address - Phone:435-843-1342
Mailing Address - Fax:435-775-9272
Practice Address - Street 1:576 E HIGHWAY 138
Practice Address - Street 2:SUITE 350
Practice Address - City:STANSBURY PARK
Practice Address - State:UT
Practice Address - Zip Code:84074-4027
Practice Address - Country:US
Practice Address - Phone:435-843-1342
Practice Address - Fax:435-775-9272
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2015-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ID0-175207Q00000X
UT8554520-1204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDG51125Medicare UPIN