Provider Demographics
NPI:1790929719
Name:ROLLOW, WILLIAM COOPER (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:COOPER
Last Name:ROLLOW
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 1:11884 BRIGHT PSGE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4369
Mailing Address - Country:US
Mailing Address - Phone:410-715-5257
Mailing Address - Fax:
Practice Address - Street 1:9501 OLD ANNAPOLIS RD STE 205
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-6336
Practice Address - Country:US
Practice Address - Phone:410-648-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine