Individual
RAYMOND D. FOWLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4300 BARTLETT ST, SOUTH PENISULA HOSPITAL, HOMER, AK 99603-7005
(907) 235-8101
Mailing address
40914 CRESTED CRANE ST, HOMER, AK 99603-9465
(907) 235-9440
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
30104
AZ
207L00000X
Anesthesiology Physician
Primary
4624
AK
207L00000X
Anesthesiology Physician
6970A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD46242
—
AK
Enumeration date
11/16/2005
Last updated
07/08/2007
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