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General NPI Number Information
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NPI Number | 1023661022
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Entity Type | Individual
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Provider Name | COSMO FOWLER MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 135 N PARK PL STE 200
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7209
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Country | US
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Telephone | 678-289-7960
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Fax | 678-289-7962
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Provider Business Mailing Address
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Address Line | 275 COLLIER RD NW STE 300
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City | ATLANTA
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State | GA
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Zip | 30309-1740
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Country | US
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Telephone | 678-289-7960
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Fax | 678-289-7962
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 102571
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 102571
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 57.248169
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 57.248169
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License Number State | OH
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