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General NPI Number Information
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NPI Number | 1598734873
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Entity Type | Individual
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Provider Name | LAWRENCE J FOWLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 02/28/2025
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Provider Practice Location Address
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Address Line | 19455 DEERFIELD AVE STE 212
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City | LANSDOWNE
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State | VA
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Zip | 20176-8102
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Country | US
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Telephone | 703-723-3670
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Fax | 877-325-2018
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Provider Business Mailing Address
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Address Line | ONE GI CREDENTIALING DEPARTMENT PO BOX 381468
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City | GERMANTOWN
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State | TN
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Zip | 38183-1468
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Country | US
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Telephone |
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | F1549
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101271261
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License Number State | VA
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