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NPI Code Detail

MEDICARE: DR. SCOTT MICHAEL BOWMAN OTRL

MEDICARE: DR. SCOTT MICHAEL BOWMAN OTRL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist012454-1NY

General Provider Information

NPI Number : 1063632172
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT MICHAEL BOWMAN OTRL
Provider Business Mailing Address
First Line : 11050 MT. BELVEDERE BLVD.
Second Line :
City : FORT DRUM
State : NY
Zip : 13602-5004
Country : US
Telephone Number : 315-774-4953
Fax Number :
Provider Business Practice Location Address
First Line : 11050 MT. BELVEDERE BLVD.
Second Line :
City : FORT DRUM
State : NY
Zip : 13602-5004
Country : US
Telephone Number : 315-774-4953
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2007
Last Update Date : 05/14/2026

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