Provider Demographics
NPI:1124057096
Name:BARROWMAN, ROGER A (MD)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:A
Last Name:BARROWMAN
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 1:22 WANDER CT
Mailing Address - Street 2:
Mailing Address - City:GLENMONT
Mailing Address - State:NY
Mailing Address - Zip Code:12077-3522
Mailing Address - Country:US
Mailing Address - Phone:518-475-1150
Mailing Address - Fax:
Practice Address - Street 1:600 MCCLELLAN ST
Practice Address - Street 2:@ ST. CLARES ER DEPT.
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-1009
Practice Address - Country:US
Practice Address - Phone:518-383-5450
Practice Address - Fax:518-383-4223
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150372-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01246753Medicaid
NY01246753Medicaid