Healthcare Provider Details
I. General information
NPI: 1023279395
Provider Name (Legal Business Name): BRYAN PARKER ROWE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/19/2008
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 ELLIOT WAY
MANCHESTER NH
03103-3502
US
IV. Provider business mailing address
33 RIVER FRONT DR UNIT #10
MANCHESTER NH
03102-3209
US
V. Phone/Fax
- Phone: 603-663-1800
- Fax:
- Phone: 917-658-5231
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0203X |
| Taxonomy | Therapeutic Radiology Physician |
| License Number | 00000000000 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 15594 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: