Provider Demographics
NPI:1760495030
Name:ROWIN, JULIE (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ROWIN
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 1:1835 W SR 89A STE 3
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5570
Mailing Address - Country:US
Mailing Address - Phone:928-300-1565
Mailing Address - Fax:928-852-2039
Practice Address - Street 1:1835 W SR 89A STE 3
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5570
Practice Address - Country:US
Practice Address - Phone:928-300-1565
Practice Address - Fax:928-852-2039
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64555202D00000X
IL036-0953102084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400235923OtherINDIVIDUAL PTAN
AZ64555OtherSTATE LICENSE
IL036095310OtherSTATE LICENSE