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General NPI Number Information
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NPI Number | 1114560778
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Entity Type | Individual
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Provider Name | ROBERT ROWEN MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | 2200 COUNTY CENTER DR STE C
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City | SANTA ROSA
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State | CA
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Zip | 95403-3000
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Country | US
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Telephone | 707-578-7787
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Fax |
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Provider Business Mailing Address
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Address Line | 321 S MAIN ST # 537
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City | SEBASTOPOL
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State | CA
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Zip | 95472-4208
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Country | US
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Telephone | 707-328-3012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G39465
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License Number State | CA
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