Healthcare Provider Details

I. General information

NPI: 1558771410
Provider Name (Legal Business Name): MICHAEL PATRICK BOWEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 N SCOTTSDALE RD STE C190
SCOTTSDALE AZ
85253-3754
US

IV. Provider business mailing address

7373 N SCOTTSDALE RD STE C190
SCOTTSDALE AZ
85253-3754
US

V. Phone/Fax

Practice location:
  • Phone: 480-612-9596
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA139312
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number65552
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number65552
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: