MEDICARE: DR. BRIAN PAUL BOWERS DO

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	207RR0500X	Rheumatology Physician	1384	SD

General Provider Information

NPI Number	:	1891877098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN PAUL BOWERS DO

Provider Business Mailing Address
First Line	:	353 FAIRMONT BLVD
Second Line	:	ATTEN CHRISTIE MSS
City	:	RAPID CITY
State	:	SD
Zip	:	57701-7350
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 FLORMANN ST
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-4579
Country	:	US
Telephone Number	:	605-718-3300
Fax Number	:	605-718-3426

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	12/17/2013

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