Individual
SHANNON BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 CAMPUS RIDGE DR STE 2200, MIDLAND, MI 48640
(989) 837-9250
Mailing address
4401 CAMPUS RIDGE DR STE 2200, MIDLAND, MI 48640-6127
(989) 837-9250
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301119017
MI
390200000X
Student in an Organized Health Care Education/Training Program
4301109762
MI
Other
Enumeration date
08/02/2016
Last updated
06/21/2019
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