Fowler, Wyatt Charles

Fowler, Wyatt Charles is an individual health care provider with primary practice located at 125 Queens Rd Ste 430 , Charlotte NC 28204-3215. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Fowler, Wyatt Charles can be contacted via phone (980) 302-6300.

Contact Information

Primary practice address
125 Queens Rd Ste 430 Charlotte NC 28204-3215
Phone: (980) 302-6300
Fax: (980) 302-6305
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X 38940 North Carolina
Allopathic & Osteopathic Physicians / Surgery 208600000X 38940 North Carolina

Profile Details

NPI number 1730287111
LBN Legal business name Fowler, Wyatt Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Aug 13th, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730287111 NPPES
North Carolina MEDICAID 8910272
North Carolina Other 10272
North Carolina MEDICAID N38940

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