Provider Demographics
NPI:1780666057
Name:ROWLEY, ROBB K (MD)
Entity Type:Individual
Prefix:
First Name:ROBB
Middle Name:K
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 400010
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89140-0010
Mailing Address - Country:US
Mailing Address - Phone:702-478-2424
Mailing Address - Fax:702-735-9074
Practice Address - Street 1:5155 S DURANGO DR STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0174
Practice Address - Country:US
Practice Address - Phone:702-478-2424
Practice Address - Fax:702-735-9074
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11465207R00000X
NV11302207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101786Medicare PIN