Provider Demographics
NPI:1518263102
Name:DUANE A ROWLEY JR DPM PC
Entity Type:Organization
Organization Name:DUANE A ROWLEY JR DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROWLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:810-969-4016
Mailing Address - Street 1:3273 DAVISON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2902
Mailing Address - Country:US
Mailing Address - Phone:810-969-4016
Mailing Address - Fax:810-245-6993
Practice Address - Street 1:3273 DAVISON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2902
Practice Address - Country:US
Practice Address - Phone:810-969-4016
Practice Address - Fax:810-245-6993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001737213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI4389Medicare PIN
MI6794120001Medicare NSC