Grady Fowler - Physician Assistant in Albuquerque, New Mexico | ProviderWire

Full Name

Grady Fowler

NPI Number

1033756887

NPI Type

Individual Provider

Gender

Male

Enumeration Date

11/27/2019

Specialties

(Taxonomies)

Name

Physician Assistant

Code

363A00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing

Location

Address

2100 LOUISIANA BLVD NE

2100 LOUISIANA BLVD NE STE 410

City

Albuquerque

Albuquerque

State

NM

NM

Postal Code

87110-5412

87110-5412

Country

US

US

Telephone Number

(505) 724-4300

(505) 724-4300

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/06/2022

Provider Address

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