Provider Demographics
NPI:1437142411
Name:GONZALES-CHAMBERS, ROWENA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROWENA
Middle Name:
Last Name:GONZALES-CHAMBERS
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 1:1 UNDERCLIFF TER
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2173
Mailing Address - Country:US
Mailing Address - Phone:304-425-1453
Mailing Address - Fax:304-425-7343
Practice Address - Street 1:1 UNDERCLIFF TER
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2173
Practice Address - Country:US
Practice Address - Phone:304-425-1453
Practice Address - Fax:304-425-7343
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16150207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0072919000Medicaid
WVE75199Medicare UPIN
WV0072919000Medicaid