Provider Demographics
NPI:1013083443
Name:BOWMAN, ERIC WILSON (ED M)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:WILSON
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:ED M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LONGFELLOW RD
Mailing Address - Street 2:
Mailing Address - City:WENHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01984-1329
Mailing Address - Country:US
Mailing Address - Phone:978-468-1428
Mailing Address - Fax:
Practice Address - Street 1:11 LONGFELLOW RD
Practice Address - Street 2:
Practice Address - City:WENHAM
Practice Address - State:MA
Practice Address - Zip Code:01984-1329
Practice Address - Country:US
Practice Address - Phone:978-468-1428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor