Individual
DR. KENNETH PATRICK FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 MERRIMACK ST, LAWRENCE, MA 01843-1756
(978) 557-8900
(978) 557-8811
Mailing address
500 MERRIMACK ST, LAWRENCE, MA 01843-1756
(978) 557-8900
(978) 557-8811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
232594
MA
208000000X
Pediatrics Physician
Primary
232594
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0043950
NEIGHBORHOOD HEALTH PLAN
MA
05
—
110077563A
—
MA
01
—
1699849166
HMO BLUE
MA
05
—
2144409
—
MA
01
—
28-38773
EVERCARE
MA
01
—
30209506
NH MEDICAID
NH
01
—
497022
TUFTS
MA
01
—
9013557
CIGNA
MA
01
—
946322-02
NETWORK
MA
01
—
9931092
AETNA NON HMO
MA
01
—
AA100849
HARVARD PILGRIM HEALTH CARE
MA
01
—
J42491
BCBS
MA
Enumeration date
11/17/2006
Last updated
11/19/2012
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