Individual
DR. STEPHEN DERRICK FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2042 EASTLAKE AVE E, UNIT C, SEATTLE, WA 98102-3594
(502) 296-8921
(502) 296-8921
Mailing address
2042 EASTLAKE AVE E, UNIT C, SEATTLE, WA 98102-3594
(502) 296-8921
(502) 296-8921
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
60147300
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0309214
—
NJ
05
—
102756338
—
PA
Enumeration date
07/08/2008
Last updated
04/07/2016
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