Provider Demographics
NPI:1417156514
Name:ROWLANDS, RANDY (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:ROWLANDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 SUNSET AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4556
Mailing Address - Country:US
Mailing Address - Phone:732-897-7544
Mailing Address - Fax:732-897-7545
Practice Address - Street 1:3200 SUNSET AVE STE 107
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4556
Practice Address - Country:US
Practice Address - Phone:732-897-7544
Practice Address - Fax:732-897-7545
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08265400207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ142202PU2Medicare PIN