Individual
LENNON E. BOWEN IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
18586
MS
2084N0600X
Clinical Neurophysiology Physician
18586
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02277207
—
MS
01
—
646000515
COMMERCIAL
—
01
—
P00280787
RAILROAD MEDICARE
—
Enumeration date
06/11/2006
Last updated
12/14/2018
Update your record
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