Provider Demographics
NPI:1407416225
Name:FOWLER, SARAH (OD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FOWLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 FAYETTEVILLE RD STE 296
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8286
Mailing Address - Country:US
Mailing Address - Phone:888-215-0393
Mailing Address - Fax:
Practice Address - Street 1:6910 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9714
Practice Address - Country:US
Practice Address - Phone:888-215-0393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2750152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist