Individual
WILLIAM C FOWLKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
67 THOMAS JOHNSON DR, SUITE 4, FREDERICK, MD 21702-4863
(301) 607-0444
(301) 831-4495
Mailing address
4110 ASPEN HILL RD, SUITE 200, ROCKVILLE, MD 20853-2853
(301) 438-5150
(301) 460-0199
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
D0067685
MD
2085R0202X
Diagnostic Radiology Physician
Primary
D0067685
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415144500
—
MD
01
—
NPI
MEDICARE - COMMUNITY RADIOLOGY ASSOCIATES
—
05
—
NPI
—
VA
01
—
P0064443
RR MEDICARE
—
01
—
P00644447
RR MEDICARE
—
Enumeration date
09/15/2006
Last updated
12/20/2013
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