MEDICARE: FREDERICK ROWLAND MD

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	246645	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	002113901	OTHER	MA	MEDICARE PTAN

General Provider Information

NPI Number	:	1982607917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FREDERICK ROWLAND MD

Provider Business Mailing Address
First Line	:	1200 CENTRE ST
Second Line	:	DEPARTMENT OF MEDICINE
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-1000
Country	:	US
Telephone Number	:	617-363-8293
Fax Number	:	617-363-8929

Provider Business Practice Location Address
First Line	:	1200 CENTRE ST
Second Line	:	DEPARTMENT OF MEDICINE
City	:	ROSLINDALE
State	:	MA
Zip	:	02131-1000
Country	:	US
Telephone Number	:	617-363-8293
Fax Number	:	617-363-8929

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	03/03/2015

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