MEDICARE: DAVID EDWARD ROWLEY NAVY IDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1710I1002X	Independent Duty Corpsman		CA

General Provider Information

NPI Number	:	1346449691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID EDWARD ROWLEY NAVY IDC

Provider Business Mailing Address
First Line	:	USS CARR (FFG 52)
Second Line	:	FPO-AE
City	:	NORFOLK
State	:	VA
Zip	:	09566-1506
Country	:	US
Telephone Number	:	757-445-6510
Fax Number	:

Provider Business Practice Location Address
First Line	:	USS CARR
Second Line	:
City	:	NORFOLK
State	:	USA
Zip	:	09566-1506
Country	:	UM
Telephone Number	:	757-445-1506
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/17/2007

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