Basic Information
Provider Information
NPI: 1912045527
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOWMAN-STROUD
FirstName: CYNTHIA
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
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Mailing Information
Address1: 2200 JEFFERSON AVE
Address2: 5TH FLOOR MERCY PHO/CVO
City: TOLEDO
State: OH
PostalCode: 436047101
CountryCode: US
TelephoneNumber: 4192519830
FaxNumber: 4192511826
Practice Location
Address1: 225 MEDICAL CENTER DR
Address2: 302
City: PADUCAH
State: KY
PostalCode: 420037914
CountryCode: US
TelephoneNumber: 2704414568
FaxNumber: 2704414288
Other Information
ProviderEnumerationDate: 02/03/2007
LastUpdateDate: 06/03/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X41666KYY Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XR0997KYN Allopathic & Osteopathic PhysiciansInternal Medicine 
208000000X41666KYN Allopathic & Osteopathic PhysiciansPediatrics 
208000000XR0997KYN Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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