Healthcare Provider Details

I. General information

NPI: 1083709836
Provider Name (Legal Business Name): MARY LANGER BOWMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 CENTRAL PARK DR SUITE 209
STEAMBOAT SPRINGS CO
80487-8816
US

IV. Provider business mailing address

1135 E HIGHWAY 40
CRAIG CO
81625-1208
US

V. Phone/Fax

Practice location:
  • Phone: 970-879-8533
  • Fax: 970-879-8532
Mailing address:
  • Phone: 970-824-1088
  • Fax: 970-824-2700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34658
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: