Individual
DR. THADDEUS BRYAN BOWNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2750 CLAY EDWARDS DR, SUITE 215, NORTH KANSAS CITY, MO 64116-3237
(816) 691-5400
(816) 346-7040
Mailing address
9411 N OAK TRFY, SUITE LL1, KANSAS CITY, MO 64155-2262
(816) 436-7072
(816) 436-2743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R5809
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05271050
BCBS OF KC INDIVIDUAL
—
01
—
110128448
RAILROAD MEDICARE
—
05
—
202349809
—
MO
Enumeration date
02/02/2006
Last updated
03/05/2009
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