Healthcare Provider Details

I. General information

NPI: 1841044799
Provider Name (Legal Business Name): MILES BOWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 PARNASSUS AVE
SAN FRANCISCO CA
94143-2206
US

IV. Provider business mailing address

480 WARREN DR APT B
SAN FRANCISCO CA
94131-1008
US

V. Phone/Fax

Practice location:
  • Phone: 586-925-1449
  • Fax:
Mailing address:
  • Phone: 586-925-1449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: