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Individual

WAYNE A FOWLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
9 CENTRAL ST, LOWELL, MA 01852-1927
(978) 458-4546
(978) 934-9264
Mailing address
22 ROCKY HILL RD, ANDOVER, MA 01810-6118
(978) 623-8195
(978) 934-9264

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4051
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0312479
MA
01
151507
HARVARD PILGRIM
MA
01
158296XX
PHCS
MA
01
174713
CIGNA
MA
01
3193
ANTHEM BS
MA
01
3200852
AETNA
MA
01
35222
FALLON HEALTH CARE
MA
01
40485
NH/VERMONT BC/BS
MA
01
41642
JOHN HANCOCL/CHILDERN
MA
01
774609
TUFTS HEALTH PLAN
MA
01
980952
NTEWORKHEALTH
MA
01
W16119
BC/BS OF MASS
MA
Enumeration date
08/12/2005
Last updated
07/08/2007
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