Provider Demographics
NPI:1619368149
Name:BOWMAN, DUSTIN D (DDIV)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:D
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:DDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45064-0007
Mailing Address - Country:US
Mailing Address - Phone:513-707-8368
Mailing Address - Fax:
Practice Address - Street 1:4721 READING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-6107
Practice Address - Country:US
Practice Address - Phone:513-707-8368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist