Fowler, Matthew Bryan

Fowler, Matthew Bryan is an individual health care provider with primary practice located at 5121 S Cottonwood St , Murray UT 84107-5701. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Fowler, Matthew Bryan can be contacted via phone (801) 727-2056.

Contact Information

Primary practice address
5121 S Cottonwood St Murray UT 84107-5701
Phone: (801) 727-2056
Fax: (770) 701-6675
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X M9271 Idaho
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 12118581-1205 Utah

Profile Details

NPI number 1801848130
LBN Legal business name Fowler, Matthew Bryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Oct 26th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801848130 NPPES
Idaho MEDICAID 807185702
Idaho Other P00319855
Idaho MEDICAID 807185700
Idaho MEDICAID 807185701

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