Provider Demographics
NPI:1508814534
Name:ROWLAND, ALICE JODY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:JODY
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3300 OAKDALE AVE N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2926
Mailing Address - Country:US
Mailing Address - Phone:763-520-2000
Mailing Address - Fax:763-520-2099
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:SUITE 200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-520-2000
Practice Address - Fax:763-520-2099
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2009-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN35976207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN267875600Medicaid
MN060002601Medicare PIN
MN267875600Medicaid