Provider Demographics
NPI:1033260195
Name:FOWLER, MICHAEL B (MB, FRCP)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:FOWLER
Suffix:
Gender:M
Credentials:MB, FRCP
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Mailing Address - Street 1:300 PASTEUR DRIVE
Mailing Address - Street 2:FALK CVRC 295
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5406
Mailing Address - Country:US
Mailing Address - Phone:650-723-7846
Mailing Address - Fax:650-725-1599
Practice Address - Street 1:300 PASTEUR DRIVE
Practice Address - Street 2:FALK CVRC 295
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5406
Practice Address - Country:US
Practice Address - Phone:650-723-7846
Practice Address - Fax:650-725-1599
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2009-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA42497207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A424971Medicare PIN