Individual
LANE ANDREW FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1000
(770) 224-2451
Mailing address
128 E APPLE ST, 2ND FLOOR, DAYTON, OH 45409-2902
(937) 208-2004
(937) 208-8828
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
00000
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2016
Last updated
05/20/2020
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