Provider Demographics
NPI:1134348865
Name:BOWLES, COLLEEN MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:MARIE
Last Name:BOWLES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-3611
Mailing Address - Country:US
Mailing Address - Phone:303-360-6276
Mailing Address - Fax:303-467-5355
Practice Address - Street 1:516 STRAND ST
Practice Address - Street 2:
Practice Address - City:FREDERIKSTED
Practice Address - State:VI
Practice Address - Zip Code:00840-3533
Practice Address - Country:US
Practice Address - Phone:340-772-0260
Practice Address - Fax:866-373-9926
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5221208000000X
CODR.0052341208000000X
VI3338208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE5221OtherTEP
NE5221OtherTEP
IL036121131OtherILLINOIS STATE LICENSE