Provider Demographics
NPI:1467459255
Name:GLEN D. ROWE, D.O., P.A.
Entity Type:Organization
Organization Name:GLEN D. ROWE, D.O., P.A.
Other - Org Name:DRS. ROWE & SCHWARTZ P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-730-4366
Mailing Address - Street 1:1093 S GOVERNORS AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-6901
Mailing Address - Country:US
Mailing Address - Phone:302-730-4366
Mailing Address - Fax:302-730-0231
Practice Address - Street 1:1093 S GOVERNORS AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-6901
Practice Address - Country:US
Practice Address - Phone:302-730-4366
Practice Address - Fax:302-730-0231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1998204134207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000836604Medicaid
DE0000836604Medicaid