Individual
DR. HAROLD JONATHAN BOWERSOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9500 MENTOR AVE, SUITE 360, MENTOR, OH 44060-8713
(440) 255-5508
(440) 357-4416
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 354-1899
(440) 354-1845
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-003486
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210429
ANTHEM
OH
05
—
0548447
—
OH
01
—
080180930
RAILROAD MEDICARE
OH
Enumeration date
08/31/2006
Last updated
02/26/2021
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