Healthcare Provider Details

I. General information

NPI: 1750360673
Provider Name (Legal Business Name): MARC A BOWMAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 W MARKET ST
LIMA OH
45801-4602
US

IV. Provider business mailing address

7285 BRODIE BLVD
DUBLIN OH
43017-8864
US

V. Phone/Fax

Practice location:
  • Phone: 419-227-3361
  • Fax: 440-579-0183
Mailing address:
  • Phone: 614-432-0274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberNA07712
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN286728
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA07712
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: