Individual
MARCIA ELIZABETH FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
15660 SAN CARLOS BLVD, UNIT # 294, FORT MYERS, FL 33908-2526
(239) 338-8069
(239) 433-1626
Mailing address
15660 SAN CARLOS BLVD., UNIT # 294, FORT MYERS, FL 33908-2889
(239) 338-8069
(239) 433-1626
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
OS7283
FL
2084B0002X
Obesity Medicine (Psychiatry & Neurology) Physician
OS7283
FL
2084P0800X
Psychiatry Physician
Primary
OS7283
FL
208D00000X
General Practice Physician
OS 7283
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000445200
—
FL
Enumeration date
08/16/2007
Last updated
08/26/2011
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