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NPI Code Detail

MEDICARE: MR. DAVID SHIELDS BOWMAN JR. PA-C

MEDICARE: MR. DAVID SHIELDS BOWMAN JR. PA-C
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
1363A00000XPhysician Assistant6090AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326429705
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID SHIELDS BOWMAN JR. PA-C
Provider Business Mailing Address
First Line : 500 W THOMAS RD STE 500
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4220
Country : US
Telephone Number : 602-406-4000
Fax Number : 602-406-6498
Provider Business Practice Location Address
First Line : 500 W THOMAS RD STE 300
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-4294
Country : US
Telephone Number : 602-406-8000
Fax Number : 602-406-3111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2015
Last Update Date : 05/23/2022

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