Provider Demographics
NPI:1558329359
Name:TOWER, JOHN EVAN (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:EVAN
Last Name:TOWER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 SOUTH BLVD E STE 110
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-6118
Mailing Address - Country:US
Mailing Address - Phone:248-853-0803
Mailing Address - Fax:248-852-5859
Practice Address - Street 1:1701 SOUTH BLVD E STE 110
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-6118
Practice Address - Country:US
Practice Address - Phone:248-853-0803
Practice Address - Fax:248-852-5859
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009426207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00044467956OtherAETNA
MI5631272OtherBLUE CROSS BLUE SHIELD
MI1234880420106OtherHUMANA
MI383265423OtherPPOM
MI383265423OtherHARRINGTON BENIFITS
MI383265423OtherCOMMERCIAL INSURANCES
MI383265423OtherUNITED HEALTH CARE
MI383265423 0005OtherCIGNA
MI00044467956OtherAETNA
MI5631272OtherBLUE CROSS BLUE SHIELD
MI1234880420106OtherHUMANA