Provider Demographics
NPI:1457667800
Name:ROWAN PSYCHIATRIC AND MEDICAL SERVICES PA
Entity Type:Organization
Organization Name:ROWAN PSYCHIATRIC AND MEDICAL SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESHREE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMPKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-636-9368
Mailing Address - Street 1:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28145-0337
Mailing Address - Country:US
Mailing Address - Phone:704-636-9368
Mailing Address - Fax:704-500-2720
Practice Address - Street 1:310 STATESVILLE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2368
Practice Address - Country:US
Practice Address - Phone:704-637-1888
Practice Address - Fax:704-637-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01345174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty