Robert B Bowlin
Individual provider Active NPI Paramedic · San Fidel, NM
NPI 1104096171 · NPPES record last updated Mar 6, 2008
Key facts
- NPI
- 1104096171
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Paramedic 146L00000X
- License
- 00015462 (NM)
- Practice address
- Exit 102 Off I - 40 1/2 Mi South
San Fidel, NM 87049-0130 - Phone
- (505) 552-5385
- Fax
- (505) 552-5473
- NPI assigned
- Mar 6, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00015462 | NM | MD | Paramedic |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Paramedic | 146L00000X | 00015462 | NM | Yes |
Addresses
Primary practice location
Exit 102 Off I - 40 1/2 Mi South
San Fidel, NM 87049-0130
Mailing address
PO Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5385
Other providers in San Fidel, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.