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Individual

MR. GERARD JOSEPH FOWLER II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CO, BOCO, C. PED.

Contact information

Practice address
280 PLEASANT ST, UNIT #3, CONCORD, NH 03301-2553
(603) 228-7159
(603) 225-4265
Mailing address
280 PLEASANT ST, UNIT #3, CONCORD, NH 03301-2553
(603) 228-7159
(603) 225-4265

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12Y002242NH01
ANTHEM BLUE CROSS/BLUE SH
01
2264576
CIGNA
05
30761501
NH
01
4665514
AETNA
NH
01
706167
HARVARD PILGRIM
Enumeration date
07/31/2006
Last updated
07/08/2007
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