Provider Demographics
NPI:1871910091
Name:FOWLER, MATTHEW LEVI (DO, PHD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:LEVI
Last Name:FOWLER
Suffix:
Gender:M
Credentials:DO, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2386 SPRINGS RD NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3066
Mailing Address - Country:US
Mailing Address - Phone:828-732-5400
Mailing Address - Fax:828-732-5401
Practice Address - Street 1:2386 SPRINGS RD NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3066
Practice Address - Country:US
Practice Address - Phone:828-732-5400
Practice Address - Fax:828-732-5401
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-26
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-00402207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine