Provider Demographics
NPI:1013909662
Name:BOWMAN, MICHAEL WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20130 ROUTE 19
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6218
Mailing Address - Country:US
Mailing Address - Phone:724-933-3300
Mailing Address - Fax:724-933-3332
Practice Address - Street 1:20130 ROUTE 19
Practice Address - Street 2:SUITE 1100
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6218
Practice Address - Country:US
Practice Address - Phone:724-933-3300
Practice Address - Fax:724-933-3332
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026214E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010663930001Medicaid
PA0010663930001Medicaid
477488Medicare PIN