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NPI Code Detail

MEDICARE: DR. JILL MICHELLE BOWERMAN D.O.

MEDICARE: DR. JILL MICHELLE BOWERMAN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianJB012172MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2JB012172OTHERBCBSM

General Provider Information

NPI Number : 1417936410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JILL MICHELLE BOWERMAN D.O.
Provider Business Mailing Address
First Line : 4344 STATE ST
Second Line :
City : SAGINAW
State : MI
Zip : 48603-4074
Country : US
Telephone Number : 989-791-0452
Fax Number : 989-791-2007
Provider Business Practice Location Address
First Line : 700 COOPER AVE
Second Line :
City : SAGINAW
State : MI
Zip : 48602-5383
Country : US
Telephone Number : 989-583-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2006
Last Update Date : 11/15/2007

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