Individual
JOHN BRIAN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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