Provider Demographics
NPI:1477221562
Name:BOWER, WILLIAM (MS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:BOWER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29488 WOODWARD AVE # 145
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-0903
Mailing Address - Country:US
Mailing Address - Phone:248-571-9065
Mailing Address - Fax:248-282-2195
Practice Address - Street 1:2310 ROCHESTER RD APT 109
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-3672
Practice Address - Country:US
Practice Address - Phone:248-571-9065
Practice Address - Fax:248-282-2195
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator