Michael D Fowler I, ST, MA
Individual provider Active NPI Case Management Agency · Camilla, GA
NPI 1700216280 · NPPES record last updated Jul 16, 2014
Key facts
- NPI
- 1700216280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Agency 251B00000X
- Practice address
- 198 S. Macarthur Drive
Camilla, GA 31730 - Phone
- (229) 375-4821
- NPI assigned
- Nov 19, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Yes |
Addresses
Primary practice location
198 S. Macarthur Drive
Camilla, GA 31730
Mailing address
198 S. Macarthur Drive
Camilla, GA 31730
Phone (229) 375-4821
Other providers in Camilla, GA
- Ellery Farrell
- Lashun Flanders
- Caitlin Fletcher
- Flint River Physical Therapy LLC
- Sherrell Fountain
- Marilyn Frazier-Rice
- Andrea Freeman
- Cecil H Fussell Jr.
- Jenna Roberts Garrett
- Melissa Gass
All providers in Camilla, GA · Case Management Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.