Healthcare Provider Details

I. General information

NPI: 1982607917
Provider Name (Legal Business Name): FREDERICK ROWLAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CENTRE ST DEPARTMENT OF MEDICINE
ROSLINDALE MA
02131-1000
US

IV. Provider business mailing address

1200 CENTRE ST DEPARTMENT OF MEDICINE
ROSLINDALE MA
02131-1000
US

V. Phone/Fax

Practice location:
  • Phone: 617-363-8293
  • Fax: 617-363-8929
Mailing address:
  • Phone: 617-363-8293
  • Fax: 617-363-8929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number246645
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: