Provider Demographics
NPI:1083709836
Name:BOWMAN, MARY LANGER (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:LANGER
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1135 E HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-1208
Mailing Address - Country:US
Mailing Address - Phone:970-824-1088
Mailing Address - Fax:970-824-2700
Practice Address - Street 1:940 CENTRAL PARK DR
Practice Address - Street 2:SUITE 209
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8816
Practice Address - Country:US
Practice Address - Phone:970-879-8533
Practice Address - Fax:970-879-8532
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO34658207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01346584Medicaid
CO01346584Medicaid