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NPI Code Detail

MEDICARE: ROWE SANDERS CROWDER III M.D.

MEDICARE:   ROWE SANDERS CROWDER III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician14176MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053369801
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROWE SANDERS CROWDER III M.D.
Provider Business Mailing Address
First Line : 952 GREEN MEADOW RD
Second Line :
City : BAY ST LOUIS
State : MS
Zip : 39520-1620
Country : US
Telephone Number : 228-463-1649
Fax Number :
Provider Business Practice Location Address
First Line : 952 GREEN MEADOW RD
Second Line :
City : BAY ST LOUIS
State : MS
Zip : 39520-1620
Country : US
Telephone Number : 228-463-1649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 06/24/2016

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