| Harold J. Bowersox, D.o., Inc | |
|
34950 Chardon Road Suite 206 Willoughby Hills OH 44094 | |
| (440) 602-7700 | |
| (440) 602-9540 |
| Full Name | Harold J. Bowersox, D.o., Inc |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 34950 Chardon Road, Willoughby Hills, Ohio |
| Authorized Official Name and Position | Harold Jonathan Bowersox (PHYSICIAN) |
| Authorized Official Contact | 4406027700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harold J. Bowersox, D.o., Inc 34950 Chardon Rd Suite 206 Willoughby OH 44094-9162 Ph: (440) 602-7700 | Harold J. Bowersox, D.o., Inc 34950 Chardon Road Suite 206 Willoughby Hills OH 44094 Ph: (440) 602-7700 |
| NPI Number | 1174611453 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 11/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174611453 | NPI | - | NPPES |
| 2731422 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |