Individual
DR. JOHN MICHAEL FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 S EAGLE RD, MERIDIAN, ID 83642-6351
(208) 706-5000
Mailing address
3080 E GENTRY WAY STE 210, MERIDIAN, ID 83642-3013
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
3871592
ID
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TRN37614
FL
Other
Enumeration date
06/29/2023
Last updated
04/22/2026
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