Healthcare Provider Details

I. General information

NPI: 1912948209
Provider Name (Legal Business Name): JOHN DAVID BOWMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 10/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8266 ATLEE RD SUITE 133
MECHANICSVILLE VA
23116-1804
US

IV. Provider business mailing address

9210 ARBORETUM PKWY SUITE 260
RICHMOND VA
23236-3472
US

V. Phone/Fax

Practice location:
  • Phone: 804-730-2121
  • Fax: 804-730-9024
Mailing address:
  • Phone: 804-915-4602
  • Fax: 804-327-8496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number101027664
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: