Healthcare Provider Details

I. General information

NPI: 1891012852
Provider Name (Legal Business Name): ISAAC ALEXANDER BOWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 08/06/2025
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2946 E BANNER GATEWAY DR
GILBERT AZ
85234-2165
US

IV. Provider business mailing address

2946 E BANNER GATEWAY DR
GILBERT AZ
85234-2165
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-6444
  • Fax: 480-256-3359
Mailing address:
  • Phone: 480-256-6444
  • Fax: 480-256-3359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number62482
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: