Healthcare Provider Details

I. General information

NPI: 1962479253
Provider Name (Legal Business Name): MICHAEL L. BOWE-RAHMING HMC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 476 BOX 779
FPO AP
96322
JP

IV. Provider business mailing address

PSC 476 BOX 779
FPO AP
96322
JP

V. Phone/Fax

Practice location:
  • Phone: 01181956501211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: