Individual
MRS. SUSAN MARIE DAUGHARTY FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2207 IRONWOOD PL, COEUR DALENE, ID 83814
(208) 667-1200
(208) 667-3994
Mailing address
2207 IRONWOOD PL, COEUR DALENE, ID 83814
(208) 667-1200
(208) 667-3994
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M5531
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002391000
—
ID
Enumeration date
02/22/2007
Last updated
04/14/2025
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