MEDICARE: BRADLEY STEVEN BOWDINO M.D.

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	207T00000X	Neurological Surgery Physician	21793	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00252062	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	07296	OTHER	NE	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	91779	OTHER	IA	BCBS

General Provider Information

NPI Number	:	1376511840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY STEVEN BOWDINO M.D.

Provider Business Mailing Address
First Line	:	8005 FARNAM DR STE 305
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-3426
Country	:	US
Telephone Number	:	402-390-4111
Fax Number	:	402-390-4115

Provider Business Practice Location Address
First Line	:	8005 FARNAM DR STE 305
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-3426
Country	:	US
Telephone Number	:	402-390-4111
Fax Number	:	402-390-4115

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

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	12/13/2023

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Directions to “ BRADLEY STEVEN BOWDINO M.D.” Practice Location

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