| Mrs Susan Marie Daugharty Fowler, MD | |
|
2207 Ironwood Pl, Coeur Dalene, ID 83814 | |
| (208) 667-1200 | |
| (208) 667-3994 |
| Full Name | Mrs Susan Marie Daugharty Fowler |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 40 Years |
| Location | 2207 Ironwood Pl, Coeur Dalene, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073648945 | NPI | - | NPPES |
| 002391000 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M5531 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Eden Home Health | Sandpoint, ID | Home health agency |
| Advanced Home Care Of Coeur D'alene | Coeur d'alene, ID | Home health agency |
| Hospice Of North Idaho | Hayden, ID | Hospice |
| Kootenai Health | Coeur d'alene, ID | Hospital |
| Bonner General Hospital | Sandpoint, ID | Hospital |
| Benewah Community Hospital | St maries, ID | Hospital |
| Shoshone Medical Center | Kellogg, ID | Hospital |
| Northwest Specialty Hospital | Post falls, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kootenai Health Inc | 1355792276 | 382 |
| Entity Name | Kootenai Health, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235288655 PECOS PAC ID: 4789641598 Enrollment ID: O20041214000230 |
| Entity Name | Kootenai Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174661151 PECOS PAC ID: 1355792276 Enrollment ID: O20240111003252 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Susan Marie Daugharty Fowler, MD 2207 Ironwood Pl, Coeur Dalene, ID 83814 Ph: (208) 667-1200 | Mrs Susan Marie Daugharty Fowler, MD 2207 Ironwood Pl, Coeur Dalene, ID 83814 Ph: (208) 667-1200 |