Individual
JOHN BRIAN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 BOILING SPRINGS RD STE 2500, SPARTANBURG, SC 29303-4214
(864) 585-5433
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19731
SC
208M00000X
Hospitalist Physician
19731
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197316
—
SC
05
—
690618W
—
NC
01
—
G910385019
MEDICARE PIN
SC
01
—
PO1240739
RAILROAD MEDICARE
SC
01
—
SCA4519225
MEDICARE PIN
SC
Enumeration date
02/02/2006
Last updated
05/31/2019
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