Provider Demographics
NPI:1043218464
Name:ROWLEY, SHARI LYN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARI
Middle Name:LYN
Last Name:ROWLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 TERRALAGO WAY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-2918
Mailing Address - Country:US
Mailing Address - Phone:801-545-0818
Mailing Address - Fax:
Practice Address - Street 1:361 MANTI DR
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-5120
Practice Address - Country:US
Practice Address - Phone:801-545-0818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL120698207PE0004X
UT49032071205207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTP00207996OtherRAIL ROAD
UTD4150Medicaid
UT49032078914001OtherBLUE CROSS BLUE SHIELD
UT005787607Medicare PIN
UTG73086Medicare UPIN
UT005784402Medicare ID - Type Unspecified