MEDICARE: DR. DANIEL S. BOWERMAN D.C., F.A.C.O.

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	111NX0800X	Orthopedic Chiropractor	DC001839L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2633236	OTHER	PA	AETNA
2	000614	OTHER	PA	HIGHMARK BLUE SHIELD
3	0060992000	OTHER	PA	KHPE HMO
4	0060992000	OTHER	PA	IBC PERSONAL CHOICE
5	J000614	OTHER	PA	AMERIHEALTH ADMINISTRATOR

General Provider Information

NPI Number	:	1235109406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL S. BOWERMAN D.C., F.A.C.O.

Provider Business Mailing Address
First Line	:	512 S 4TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-1507
Country	:	US
Telephone Number	:	215-923-5577
Fax Number	:	215-627-3530

Provider Business Practice Location Address
First Line	:	512 S 4TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-1507
Country	:	US
Telephone Number	:	215-923-5577
Fax Number	:	215-627-3530

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. DANIEL S. BOWERMAN D.C., F.A.C.O.” Practice Location

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