Grady Fowler

NPI #1033756887 in Albuquerque, New Mexico

Provider Information

NPI Number: 1033756887
Entity Type: Individual
Name: Grady Fowler
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Nov 27, 2019
Last Updated: Jan 6, 2022

Practice Location

Address: 2100 LOUISIANA BLVD NE STE 410
City: Albuquerque
State: New Mexico
ZIP Code: 87110-5412
Phone: (505) 724-4300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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