Provider Demographics
NPI:1770579278
Name:BOWSER, MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BOWSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:101 UNION AVE
Mailing Address - Street 2:SUITE 601
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2761
Mailing Address - Country:US
Mailing Address - Phone:315-234-0906
Mailing Address - Fax:315-234-4416
Practice Address - Street 1:101 UNION AVE
Practice Address - Street 2:SUITE 607
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2761
Practice Address - Country:US
Practice Address - Phone:315-448-6215
Practice Address - Fax:315-234-4416
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY109280207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
B80305Medicare UPIN