Individual
DR. RICHARD F FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6315 E MAIN ST, SUITE 4, MESA, AZ 85205-8953
(480) 830-4164
(480) 830-5009
Mailing address
6315 E MAIN ST, SUITE 4, MESA, AZ 85205-8953
(480) 830-4164
(480) 830-5009
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16349
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0250000
BLUE CROSS BLUE SHEILD
AZ
Enumeration date
12/20/2005
Last updated
02/13/2009
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