Provider Demographics
NPI:1114346921
Name:ROEWE, RAYMOND FARLOW JR
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:FARLOW
Last Name:ROEWE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LANGWORTHY ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7365
Mailing Address - Country:US
Mailing Address - Phone:563-584-3490
Mailing Address - Fax:563-584-3215
Practice Address - Street 1:1000 LANGWORTHY ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7365
Practice Address - Country:US
Practice Address - Phone:563-584-3490
Practice Address - Fax:563-584-3215
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-46426208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology