Provider Demographics
NPI:1326058413
Name:BOWE, CLIFFORD T (MD)
Entity Type:Individual
Prefix:MR
First Name:CLIFFORD
Middle Name:T
Last Name:BOWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:322 N MAIN ST
Mailing Address - City:CADOTT
Mailing Address - State:WI
Mailing Address - Zip Code:54727-0069
Mailing Address - Country:US
Mailing Address - Phone:715-289-4221
Mailing Address - Fax:715-289-3534
Practice Address - Street 1:322 N MAIN ST
Practice Address - Street 2:CADOTT MEDICAL CENTER S C
Practice Address - City:CADOTT
Practice Address - State:WI
Practice Address - Zip Code:54727
Practice Address - Country:US
Practice Address - Phone:715-289-4221
Practice Address - Fax:715-723-3534
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI13372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30994300Medicaid
B51682Medicare UPIN
WI000011047Medicare ID - Type Unspecified