Individual
SHARON FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
46591 ROMEO PLANK RD, SUITE 205, MACOMB, MI 48044-5742
(586) 226-6252
(586) 226-6255
Mailing address
46591 ROMEO PLANK RD, SUITE 205, MACOMB, MI 48044-5742
(586) 226-6252
(586) 226-6255
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301071559
MI
2080A0000X
Pediatric Adolescent Medicine Physician
4301071559
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E01172
BCBSM GROUP NUMBER
MI
05
—
4255106
—
MI
Enumeration date
10/10/2005
Last updated
02/09/2012
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