MEDICARE: DR. ADAM M BOWMAN MD

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
1	174400000X	Specialist
2	207W00000X	Ophthalmology Physician	65922181205	UT

General Provider Information

NPI Number	:	1184846131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM M BOWMAN MD

Provider Business Mailing Address
First Line	:	1580 W ANTELOPE DR
Second Line	:	SUITE 175
City	:	LAYTON
State	:	UT
Zip	:	84041-1160
Country	:	US
Telephone Number	:	801-773-2233
Fax Number	:	801-773-2375

Provider Business Practice Location Address
First Line	:	1548 E 4500 S STE 105
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5209
Country	:	US
Telephone Number	:	14-243-0908
Fax Number	:	801-424-3091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	05/10/2019

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