Provider Demographics
NPI:1164513503
Name:FOWLER, PETER A (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:FOWLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4211
Mailing Address - Country:US
Mailing Address - Phone:603-474-5400
Mailing Address - Fax:603-474-2525
Practice Address - Street 1:549 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:SEABROOK
Practice Address - State:NH
Practice Address - Zip Code:03874-4211
Practice Address - Country:US
Practice Address - Phone:603-474-5400
Practice Address - Fax:603-474-2525
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1238111NN0400X
NH265-0687B111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE4406Medicare PIN