Provider Demographics
NPI:1699094532
Name:BOWMAN, MICHELLE CARROLL (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:CARROLL
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 MONTGOMERY RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2280
Mailing Address - Country:US
Mailing Address - Phone:513-961-5558
Mailing Address - Fax:
Practice Address - Street 1:4805 MONTGOMERY RD STE 410
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2280
Practice Address - Country:US
Practice Address - Phone:513-241-2370
Practice Address - Fax:513-241-6053
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1238332084N0400X
OH35 1238332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology