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NPI Code Detail

MEDICARE: MARY FOWLER

MEDICARE:   MARY  FOWLER
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1881127504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY FOWLER
Provider Business Mailing Address
First Line : PO BOX 1869
Second Line :
City : SPARTANBURG
State : SC
Zip : 29304-1869
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 325 S CHURCH ST
Second Line :
City : SPARTANBURG
State : SC
Zip : 29306-5231
Country : US
Telephone Number : 864-582-5431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2017
Last Update Date : 04/10/2017

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Directions to “ MARY FOWLER ” Practice Location

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