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General NPI Number Information
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NPI Number | 1619336344
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Entity Type | Organization
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Legal Business Name | JOHN R ROWELL MD21640
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Dates
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Enumeration Date | 02/23/2016
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 309 BELMONT AVE
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City | GREENVILLE
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State | SC
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Zip | 29601-4303
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Country | US
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Telephone | 864-242-5303
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Fax |
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Provider Business Mailing Address
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Address Line | 309 BELMONT AVE
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City | GREENVILLE
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State | SC
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Zip | 29601-4303
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Country | US
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Telephone | 864-242-5303
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Fax |
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Authorized Official
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Title or Position | MD
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Name | JOHN RUSSELL ROWELL JR.
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Credential | MD
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Telephone | 864-242-5303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 7175
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License Number State | SC
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