Healthcare Provider Details

I. General information

NPI: 1255593950
Provider Name (Legal Business Name): DR. MICHAEL ROWLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 N CASCADE AVE STE 301
COLORADO SPRINGS CO
80907-6265
US

IV. Provider business mailing address

2920 N CASCADE AVE STE 301
COLORADO SPRINGS CO
80907-6265
US

V. Phone/Fax

Practice location:
  • Phone: 719-636-1201
  • Fax: 719-636-1326
Mailing address:
  • Phone: 719-636-1201
  • Fax: 719-636-1326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301091809
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number52523
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR0067922
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: