Organization
DR. THEODORE BOWLUS, DPM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE HENRY BOWLUS DPM (OWNER)
(419) 874-4494
Entity
Organization
Contact information
Practice address
27121 OAKMEAD DR STE C, PERRYSBURG, OH 43551-2672
(567) 277-8878
(419) 353-4169
Mailing address
27121 OAKMEAD DR STE C, PERRYSBURG, OH 43551-2672
(567) 277-8878
(419) 353-4169
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0583391
—
OH
01
—
DZ3801
RAILROAD MEDICARE
OH
01
—
H176321
MEDICARE
OH
Enumeration date
11/09/2006
Last updated
04/03/2024
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