Individual
MARY I BOWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 W 5TH ST, STE A, SHERIDAN, WY 82801-2748
(307) 672-7700
Mailing address
1701 W 5TH ST, STE A, SHERIDAN, WY 82801-2748
(307) 672-7700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5199A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000011895
MONTANA MEDICAID
WY
01
—
303760
BLUE CROSS
WY
Enumeration date
06/30/2006
Last updated
07/08/2007
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