Provider Demographics
NPI:1700870995
Name:BOWMAN, MICHAEL E (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-8770
Mailing Address - Country:US
Mailing Address - Phone:740-286-0873
Mailing Address - Fax:
Practice Address - Street 1:521 E MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-2126
Practice Address - Country:US
Practice Address - Phone:740-286-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-16396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist