Individual
MR. CARL FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1305 N OAKLAND BLVD, ER DEPARTMENT, WATERFORD, MI 48327
(248) 666-9000
Mailing address
PO BOX 685, LAPEER, MI 48446
(866) 898-7139
(616) 975-9827
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
CF045243
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104195483
—
MI
01
—
CF045243
BCBS
MI
Enumeration date
07/07/2006
Last updated
05/05/2011
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