Provider Demographics
NPI:1679564744
Name:FOWLER, WILLIAM VARN (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:VARN
Last Name:FOWLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2293 SUGAR HILL RD STE D
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752-7787
Mailing Address - Country:US
Mailing Address - Phone:828-652-8727
Mailing Address - Fax:828-652-8793
Practice Address - Street 1:2293 SUGAR HILL RD STE D
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-7787
Practice Address - Country:US
Practice Address - Phone:828-652-8727
Practice Address - Fax:828-652-8793
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC23844207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1679564744Medicaid
NC33412OtherBCBS ID #
9186553OtherAETNA
NC080089803OtherMEDICARE RAILROAD ID #
NC1679564744Medicaid
NC206382EMedicare PIN