Healthcare Provider Details

I. General information

NPI: 1831775394
Provider Name (Legal Business Name): ERRIS MARIE ROWAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5629 LEE RD
INDIANAPOLIS IN
46216-2003
US

IV. Provider business mailing address

5629 LEE RD
INDIANAPOLIS IN
46216-2003
US

V. Phone/Fax

Practice location:
  • Phone: 317-415-6450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number02007514A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: