Deidre Lanae Bowman, COSMETOLOGIST

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

452804 Issued in MD

Practice address

5441 Baltimore National Pike
Baltimore, MD 21229-2102

Phone

(443) 673-7064

NPI assigned

Jan 26, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579996800000",
    "number": "1417587726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 CARVER RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212251312",
            "telephone_number": "443-673-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 BALTIMORE NATIONAL PIKE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212292102",
            "telephone_number": "443-673-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "DEIDRE",
        "middle_name": "LANAE",
        "name_prefix": "Mrs.",
        "credential": "COSMETOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-26",
        "last_updated": "2020-01-26",
        "certification_date": "2020-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "MD",
            "license": "452804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Sara Bowler, LMSW
• Deneen Bowlin, MD
• Danielle Bowling
• Kendall Baldwin Bowling
• Cecelia Bowman, LGSW
• Erin Bowman, LCPC
• Jennifer Bowman, LCSW-C
• Ma'Lai Bowman
• Mackenzie Bowman, RD, LDN
• Michael E. Bowman, LCSW-C

• Prosthetics Case Management in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Prosthetics Case Management in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.