Provider Demographics
NPI:1619991445
Name:ROWLAND, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 SHERIDAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-633-8675
Mailing Address - Fax:716-633-9231
Practice Address - Street 1:3730 SHERIDAN DRIVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226
Practice Address - Country:US
Practice Address - Phone:716-633-8675
Practice Address - Fax:716-633-9231
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11307712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000507612005OtherBLUE SHIELD OF WESTERN NY
040426000293OtherFIDELIS
000507612001OtherBLUE SHIELD OF WESTERN NY
300029930OtherRAILROAD MEDICARE
00025603902OtherUNIVERA
NY00664604Medicaid
050908000028OtherFIDELIS
00025603903OtherUNIVERA
1607053OtherINDEPENDANT HEALTH
1130772WOtherWORKERS COMPENSATION
300040638OtherRAILROAD MEDICARE
00025603903OtherUNIVERA
NYA96931Medicare PIN