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NPI Code Detail

MEDICARE: DR. EMILY FOWLER OMURA MD

MEDICARE: DR. EMILY FOWLER OMURA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZD0900XDermatopathology (Pathology) Physician4088AL
2207ZD0900XDermatopathology (Pathology) PhysicianME89014FL
3207ZD0900XDermatopathology (Pathology) PhysicianNC

General Provider Information

NPI Number : 1265438972
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY FOWLER OMURA MD
Provider Business Mailing Address
First Line : 3550 INDEPENDENCE DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-5710
Country : US
Telephone Number : 205-949-2806
Fax Number : 205-949-2875
Provider Business Practice Location Address
First Line : 3550 INDEPENDENCE DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-5710
Country : US
Telephone Number : 205-949-2806
Fax Number : 205-949-2875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/08/2007

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