Individual
DR. REGINALD STEPHEN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 HOWELL MILL RD NW STE 525, ATLANTA, GA 30318-2538
(404) 300-3494
(404) 350-8873
Mailing address
1800 HOWELL MILL RD NW STE 525, ATLANTA, GA 30318-2538
(404) 300-3494
(404) 350-8873
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
020995
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110202102
RR MEDICARE
—
01
—
227194900
WORKERS COMP
—
Enumeration date
11/13/2006
Last updated
03/02/2022
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