Healthcare Provider Details
I. General information
NPI: 1750336871
Provider Name (Legal Business Name): CRAIG G ROWELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 05/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2602 BUFORD RD
RICHMOND VA
23235-3422
US
IV. Provider business mailing address
211 SCRIMSHAW DR
CHESTER VA
23836-2575
US
V. Phone/Fax
- Phone: 804-272-8806
- Fax:
- Phone: 804-530-2842
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: