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General NPI Number Information
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NPI Number | 1497940282
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Entity Type | Organization
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Legal Business Name | BOWSER PODIATRY PA
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 2001 WILLOWCREST CIR
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City | BALTIMORE
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State | MD
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Zip | 21209-3730
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Country | US
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Telephone | 410-736-2241
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 WILLOWCREST CIR
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City | BALTIMORE
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State | MD
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Zip | 21209-3730
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Country | US
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Telephone | 410-736-2241
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. LLOYD THOMAS BOWSER JR.
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Credential | D.P.M.
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Telephone | 410-736-2241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 01245
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License Number State | MD
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