Individual
DR. EMILY RENEE JOHNSON FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6317 S VINEYARD AVE, SIOUX FALLS, SD 57108-3826
(612) 710-3407
Mailing address
6317 S VINEYARD AVE, SIOUX FALLS, SD 57108-3826
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
106995
MN
207L00000X
Anesthesiology Physician
56937
MN
207L00000X
Anesthesiology Physician
Primary
67422
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
Enumeration date
04/13/2012
Last updated
05/21/2024
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