=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336167147
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL P ROWANE D.O
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2006
-----------------------------------------------------
Last Update Date | 03/25/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27100 CHARDON ROAD STE 150
-----------------------------------------------------
City | RICHMOND HTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44143
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-943-6350
-----------------------------------------------------
Fax | 440-347-0930
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20800 HARVARD ROAD 2ND FLOOR
-----------------------------------------------------
City | HIGHLAND HILLS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-358-2370
-----------------------------------------------------
Fax | 216-201-4536
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 34-005632
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 34.005632
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------