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Individual

SHANE BOWMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
34 MAPLE ST, NORWALK, CT 06850-3894
(203) 852-2000
Mailing address
34 MAPLE ST, NORWALK, CT 06850-3894
(203) 852-2000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
77626
CT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
77626
CT

Other

Enumeration date
12/30/2020
Last updated
09/10/2024
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