Individual
AGNES V BOWLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6847 N CHESTNUT ST, RAVENNA, OH 44266-3929
(330) 297-0811
Mailing address
PO BOX 30716, CLEVELAND, OH 44130-0716
(440) 879-0081
(440) 879-0084
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-049892
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000142838
ANTHEM
OH
Enumeration date
02/03/2006
Last updated
07/11/2007
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