Most Relevant Information
Provider Data
| NPI Number: | 1003410416 |
| Provider Name: | WILLIAM FOWLKES |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/25/2020 |
| Last Updated: | 11/25/2020 |
Provider Practice Location
2300 WASHINGTON PL NE APT 225
WASHINGTON
DC
200181056
Practice Location Phone/Fax
| Phone: | 2025831554 |
| Fax: |
Provider Mailing Location
3206 CURTIS DR APT 708
TEMPLE HILLS
MD
207481267
Provider Mailing Phone/Fax
| Phone: | 2022945507 |
| Fax: |