Healthcare Provider Details

I. General information

NPI: 1760423776
Provider Name (Legal Business Name): DORAN ARTHUR BOWMAN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 SUNNYSIDE AVE CAROLINE CO MENTAL HEALTH CLINIC
DENTON MD
21629
US

IV. Provider business mailing address

6855 ELDORADO RD
FEDERALSBURG MD
21632
US

V. Phone/Fax

Practice location:
  • Phone: 410-479-3800
  • Fax: 410-479-0052
Mailing address:
  • Phone: 410-754-5345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR100479
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: