Fowler, Mandi C
Fowler, Mandi C is an individual health care provider with primary practice located at 677 Church St Ne , Marietta GA 30060-1101. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Fowler, Mandi C can be contacted via phone (470) 793-6120.Contact Information
Primary practice address
677 Church St Ne
Marietta GA 30060-1101
Phone: (470) 793-6120
Fax: (770) 999-2647
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 3873 | Georgia |
Profile Details
| NPI number | 1891782900 |
|---|---|
| LBN Legal business name | Fowler, Mandi C |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2005 |
| Last updated | Nov 14th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891782900 | NPPES |
| Georgia | MEDICAID | 875872035B | |
| Georgia | MEDICAID | 875872035F | |
| Georgia | MEDICAID | 647119263A | |
| Georgia | MEDICAID | 875872035C | |
| Georgia | MEDICAID | 875872035E | |
| Georgia | MEDICAID | 875872035D |
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