Provider Demographics
NPI:1528013224
Name:ROWE, KERRY (MD)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02880-0229
Mailing Address - Country:US
Mailing Address - Phone:401-788-3337
Mailing Address - Fax:401-788-3939
Practice Address - Street 1:3461 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1465
Practice Address - Country:US
Practice Address - Phone:401-471-6740
Practice Address - Fax:401-471-6753
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215393207P00000X
RIMD14269207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ25190OtherBLUE SHIELD
MA0180017Medicaid
MAJ25190OtherBLUE SHIELD
MAP00081024Medicare PIN
MAH76308Medicare UPIN