Provider Demographics
NPI:1821059510
Name:ROWAN, BRIAN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:ANTHONY
Last Name:ROWAN
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 1:300 PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-2355
Mailing Address - Country:US
Mailing Address - Phone:712-246-1230
Mailing Address - Fax:
Practice Address - Street 1:1 JACK FOSTER DR
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-4586
Practice Address - Country:US
Practice Address - Phone:712-246-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83233174400000X
GA053942207X00000X
IA42901207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6431065OtherCIGNA
GA428855242FMedicaid
FL263750200Medicaid
FL7321304OtherAETNA
FL03353OtherBCBS
GA428855242FMedicaid
FL0721200001Medicare NSC
H42489Medicare PIN
IAIB2716016Medicare Oscar/Certification
GA511I200072Medicare UPIN
FL263750200Medicaid