Provider Demographics
NPI:1457487340
Name:ROWE, ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:ROWE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4342 RIDGE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-2715
Mailing Address - Country:US
Mailing Address - Phone:216-741-3733
Mailing Address - Fax:216-749-3137
Practice Address - Street 1:4342 RIDGE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-2715
Practice Address - Country:US
Practice Address - Phone:216-741-3733
Practice Address - Fax:216-749-3137
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2882152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHT46275Medicare UPIN
OH0380201Medicare ID - Type Unspecified