Provider Demographics
NPI:1801038740
Name:KENT C. BOWDEN DO PLLC
Entity Type:Organization
Organization Name:KENT C. BOWDEN DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-268-9914
Mailing Address - Street 1:109 W FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2301
Mailing Address - Country:US
Mailing Address - Phone:989-354-0845
Mailing Address - Fax:989-354-2965
Practice Address - Street 1:1 WILLIAM CARLS DRIVE
Practice Address - Street 2:HURON VALLEY SINAI HOSPITAL
Practice Address - City:COMMERCE
Practice Address - State:MI
Practice Address - Zip Code:48382
Practice Address - Country:US
Practice Address - Phone:248-937-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016414208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty