Healthcare Provider Details

I. General information

NPI: 1952985269
Provider Name (Legal Business Name): ELIZABETH ROSE BOWLIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH ROSE LEWANDOWSKI DO

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8896 COMMERCE RD STE 5
COMMERCE TOWNSHIP MI
48382-4494
US

IV. Provider business mailing address

8896 COMMERCE RD STE 5
COMMERCE TOWNSHIP MI
48382-4494
US

V. Phone/Fax

Practice location:
  • Phone: 248-360-9241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101028322
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: