Individual
KENNETH DUANE BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 MINNESOTA DR STE 800, EDINA, MN 55435-7915
(952) 595-1100
(612) 294-4903
Mailing address
3600 MINNESOTA DR STE 800, EDINA, MN 55435-7915
(952) 595-1100
(612) 294-4903
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01057766
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000371886
ANTHEM BCBS
IN
01
—
063182
SIHO
IN
05
—
200523120
—
IN
05
—
64106941
—
KY
01
—
P00242551
MEDICARE RAILROAD
—
01
—
P00632696
RAILROAD MEDICARE
IN
01
—
P00764115
RAILROAD MEDICARE
IN
Enumeration date
06/30/2006
Last updated
03/11/2026
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