Provider Demographics
NPI:1821192022
Name:BOWMAN, KAROLEN C (MD)
Entity Type:Individual
Prefix:
First Name:KAROLEN
Middle Name:C
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 13TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-4075
Mailing Address - Country:US
Mailing Address - Phone:336-667-6444
Mailing Address - Fax:336-667-4515
Practice Address - Street 1:702 13TH ST
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-4075
Practice Address - Country:US
Practice Address - Phone:336-667-6444
Practice Address - Fax:336-667-4515
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21756173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCB1249Medicare UPIN