Individual
ISHAH MARIE PRICE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
175 FORE RIVER PKWY, PORTLAND, ME 04102-2779
(207) 553-6105
Mailing address
175 FORE RIVER PKWY, PORTLAND, ME 04102-2779
(207) 553-6105
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1909
ME
Other
Enumeration date
11/04/2018
Last updated
05/03/2024
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