Individual
BRUCE T BOWLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 HOOPER RD, ENDWELL FAMILY PHYSICIANS LLP, ENDWELL, NY 13760-3698
(607) 754-3863
(607) 754-5697
Mailing address
415 HOOPER RD, ENDWELL, NY 13760-3698
(607) 754-3863
(607) 754-5697
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
116545
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00557539
—
NY
01
—
10031769
CDPHP
—
01
—
1040
EMPIRE BS
—
01
—
4210349
AETNA
—
01
—
58140
GHI HMO
—
01
—
878446
AETNA HMO
—
01
—
88510
MVP SELECT
—
01
—
9689459
GHI
—
01
—
NY0042948
CHAMPUS
—
Enumeration date
07/12/2006
Last updated
07/08/2007
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