Provider Demographics
NPI:1245365063
Name:BOWMAN, CHRISTINE MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:MARIE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 S REMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2458
Mailing Address - Country:US
Mailing Address - Phone:614-237-1372
Mailing Address - Fax:
Practice Address - Street 1:1611 TIKI LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8729
Practice Address - Country:US
Practice Address - Phone:740-687-1555
Practice Address - Fax:740-687-1691
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5338152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSC4093841Medicare ID - Type Unspecified
OHU92169Medicare UPIN