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Individual

RANDALL J BOWMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5855 BREMO RD, SUITE 207, RICHMOND, VA 23226-1930
(804) 288-3079
(804) 282-6159
Mailing address
5855 BREMO RD, SUITE 207, RICHMOND, VA 23226-1930
(804) 288-3079
(804) 282-6159

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101037433
VA
207R00000X
Internal Medicine Physician
35-053984
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
653645
OH
01
C06778
GROUP PTAN
VA
01
P00215684
RAILROAD
OH
Enumeration date
06/30/2006
Last updated
07/15/2014
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