Provider Demographics
NPI:1659594265
Name:BOWMAN, ROBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 STATESVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-3013
Mailing Address - Country:US
Mailing Address - Phone:704-371-3754
Mailing Address - Fax:704-371-3632
Practice Address - Street 1:1776 STATESVILLE AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-3013
Practice Address - Country:US
Practice Address - Phone:704-371-3754
Practice Address - Fax:704-371-3632
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist