MEDICARE: SAMUEL R ROWE

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	1041C0700X	Clinical Social Worker	S.1510384-TRNE	OH

General Provider Information

NPI Number	:	1992215479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL R ROWE

Provider Business Mailing Address
First Line	:	3138 INDIANOLA AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43202-1324
Country	:	US
Telephone Number	:	816-812-3946
Fax Number	:

Provider Business Practice Location Address
First Line	:	770 E MAIN ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1715
Country	:	US
Telephone Number	:	816-812-3946
Fax Number	:

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

Provider Enumeration Date	:	10/10/2017
Last Update Date	:	10/10/2017

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Directions to “ SAMUEL R ROWE ” Practice Location

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