Healthcare Provider Details

I. General information

NPI: 1700073822
Provider Name (Legal Business Name): ROWENA MARIANO, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 FALLS OF NEUSE RD SUITE 200
RALEIGH NC
27614-8494
US

IV. Provider business mailing address

3931 NAPA VALLEY DR
RALEIGH NC
27612-7391
US

V. Phone/Fax

Practice location:
  • Phone: 919-306-5829
  • Fax:
Mailing address:
  • Phone: 919-306-5829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateNC

VIII. Authorized Official

Name: DR. ROWENA BLAS MARIANO
Title or Position: DIRECTOR
Credential: M.D.
Phone: 919-306-5829