Fowler, Mariecken
Fowler, Mariecken is an individual health care provider with primary practice located at 11215 Metro Pkwy Ste 1 , Fort Myers FL 33966-1206. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Behavioral Neurology & Neuropsychiatry, Allopathic & Osteopathic Physicians / Diagnostic Neuroimaging. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Fowler, Mariecken can be contacted via phone (239) 208-2212.Contact Information
Primary practice address
11215 Metro Pkwy Ste 1
Fort Myers FL 33966-1206
Phone: (239) 208-2212
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2020035640 | Missouri |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | MD473597 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 0101238278 | Virginia |
| Allopathic & Osteopathic Physicians / Behavioral Neurology & Neuropsychiatry | 2084B0040X | 0101238278 | Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Neuroimaging | 2084D0003X | 0101238278 | Virginia |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 20637 | New Hampshire |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | S9132 | Texas |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | ME146337 | Florida |
Profile Details
| NPI number | 1548200116 |
|---|---|
| LBN Legal business name | Fowler, Mariecken |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Apr 5th, 2024 - about 7 months 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 | 1548200116 | NPPES |
| Virginia | Other | 196654 | ANTHEM BCBS |
| Virginia | Other | P00349159 | ANTHEM BCBS |
| Virginia | MEDICAID | 010214851 | ANTHEM BCBS |
| Virginia | Other | 001854467 | ANTHEM BCBS |
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