Individual
ROBERT E. BULOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2350 MIAMI VALLEY DR STE 310, CENTERVILLE, OH 45459-4778
(937) 438-5216
(937) 438-5229
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
34006383
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
34.006383
OH
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
34006383
OH
207RI0011X
Interventional Cardiology Physician
34006383
OH
207UN0901X
Nuclear Cardiology Physician
34006383
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000009508
ANTHEM
OH
05
—
0234517
—
OH
01
—
P00922092
RAILROAD MEDICARE PIN
OH
Enumeration date
07/14/2005
Last updated
06/16/2022
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