Doctor Name: | MR. CHAD ALLEN BOWMAN |
NPI Number: | 1710240270 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 235 S El Dorado Circle Mesa, AZ - 85202 |
Business Phone Number: | 4809682995 |
Business Fax Number: | |
Mailing Address: | 9422 E Posada Ave, MESA |
State: | AZ |
Postal Code: | 852121484 |
Phone Number: | 4805678581 |
Fax Number: | |
NPI Enumeration Date: | 06/20/2012 |
NPI Last Update Date: | 06/20/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |