Healthcare Provider Details

I. General information

NPI: 1336167147
Provider Name (Legal Business Name): MICHAEL P ROWANE D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 03/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27100 CHARDON ROAD STE 150
RICHMOND HTS OH
44143
US

IV. Provider business mailing address

20800 HARVARD ROAD 2ND FLOOR
HIGHLAND HILLS OH
44122
US

V. Phone/Fax

Practice location:
  • Phone: 440-943-6350
  • Fax: 440-347-0930
Mailing address:
  • Phone: 216-358-2370
  • Fax: 216-201-4536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34-005632
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.005632
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: