Individual
G. WILSON BOWERS
Active
Individual
G. WILSON BOWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-03-1628
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000181836
UNISON MEDICAID
OH
05
—
0112101000
—
WV
01
—
0113648
MOLINA MEDICAID
OH
05
—
0113648
—
OH
01
—
310917085056
CARESOURCE MEDICAID
OH
01
—
370002074
RR MEDICARE
—
Enumeration date
05/20/2006
Last updated
03/17/2011
Update your record
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