Healthcare Provider Details

I. General information

NPI: 1669468989
Provider Name (Legal Business Name): ROBERT A ROWE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2568A RIVA RD SUITE 205
ANNAPOLIS MD
21401-7445
US

IV. Provider business mailing address

2568A RIVA RD SUITE 205
ANNAPOLIS MD
21401-7445
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-2210
  • Fax: 410-224-4001
Mailing address:
  • Phone: 410-224-2210
  • Fax: 410-224-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberS01613
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: