Individual
MATTHEW BRYAN FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 727-2056
(770) 701-6675
Mailing address
3340 N CENTER ST STE 800, LEHI, UT 84043-7406
(801) 990-1911
(801) 990-1912
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12118581-1205
UT
207L00000X
Anesthesiology Physician
M9271
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807185700
—
ID
05
—
807185701
—
ID
05
—
807185702
—
ID
01
—
P00319855
RAILROAD MEDICARE
ID
Enumeration date
05/16/2006
Last updated
10/26/2021
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