Provider Demographics
NPI:1598771131
Name:ROWLEY, MARK CALVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:CALVIN
Last Name:ROWLEY
Suffix:
Gender:M
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 465
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381
Mailing Address - Country:US
Mailing Address - Phone:503-873-7920
Mailing Address - Fax:503-873-7340
Practice Address - Street 1:607 WELCH STREET
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381
Practice Address - Country:US
Practice Address - Phone:503-873-7920
Practice Address - Fax:503-873-7340
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18314207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD18314OtherMEDICAL LICENSE
OR057005Medicaid
D15663Medicare UPIN
0000BKHBVMedicare ID - Type Unspecified
OR057005Medicaid
ORD15663Medicare UPIN