Provider Demographics
NPI:1770554339
Name:BOWSER, ROBERT L (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:BOWSER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:250 NE MULBERRY ST
Mailing Address - Street 2:C/O SJS MEDICAL MANAGEMENT, SUITE 202
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-4533
Mailing Address - Country:US
Mailing Address - Phone:816-389-4130
Mailing Address - Fax:816-389-4140
Practice Address - Street 1:250 NE MULBERRY ST
Practice Address - Street 2:C/O SJS MEDICAL MANAGEMENT, SUITE 202
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4533
Practice Address - Country:US
Practice Address - Phone:816-389-4130
Practice Address - Fax:816-389-4140
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2009-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR8094207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203465216Medicaid
MO203465216Medicaid
MOP00662913Medicare PIN
MOJ11F594Medicare PIN