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Physician Compare National (NPI:1508915257)

HEALTHCARE PROVIDER: SUSAN MINSHEW FOWLER AUDIOLOGIST

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1508915257
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2466625017
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20111027000400
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name FOWLER
Individual professional last name
Provider First Name SUSAN
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 1984
Individual professional's medical school graduation year
Primary Specialty QUALIFIED AUDIOLOGIST
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name COMPREHENSIVE ENT P C
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 7810996899
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 2
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 5219 HICKORY PARK DR
Group Practice or individual's line 1 address
Line 2 Street Address C
Group Practice or individual's line 2 address
City GLEN ALLEN
Group Practice or individual's city
State VA
Group Practice or individual's state
Zip Code 230592618
Group Practice or individual's zip code (9 digits when available)
Phone Number 8042284480
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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