Healthcare Provider Details

I. General information

NPI: 1013076108
Provider Name (Legal Business Name): WILLIAM J BOWMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 10/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3464 S WILLOW ST SUITE 194
DENVER CO
80231-4531
US

IV. Provider business mailing address

1390 S POTOMAC ST SUITE 124
AURORA CO
80012-6165
US

V. Phone/Fax

Practice location:
  • Phone: 303-755-2900
  • Fax: 303-745-7997
Mailing address:
  • Phone: 303-368-8611
  • Fax: 303-368-9791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number21343
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: