MEDICARE: EVA LAUIE CAROLYN BOWLES 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	208600000X	Surgery Physician	94-12346	KS

General Provider Information

NPI Number	:	1376244228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA LAUIE CAROLYN BOWLES MD

Provider Business Mailing Address
First Line	:	2107 GRAND BLVD APT 909
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-1880
Country	:	US
Telephone Number	:	816-516-8366
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD # MS 2005
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-3124
Country	:	US
Telephone Number	:	913-588-6124
Fax Number	:	913-588-7540

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

Provider Enumeration Date	:	03/16/2023
Last Update Date	:	06/24/2025

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