Provider Demographics
NPI:1225852536
Name:BOWEN, JAMES ALLEN
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:BOWEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 GILMAN ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-3075
Mailing Address - Country:US
Mailing Address - Phone:734-620-1842
Mailing Address - Fax:
Practice Address - Street 1:15400 GRAND RIVER AVE FL 2
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-4124
Practice Address - Country:US
Practice Address - Phone:313-236-8027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist