Provider Demographics
NPI:1649298779
Name:ROWE, MICHAEL KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KEVIN
Last Name:ROWE
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 1:140 NEWCOMB AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:KY
Mailing Address - Zip Code:40456-2728
Mailing Address - Country:US
Mailing Address - Phone:606-256-4148
Mailing Address - Fax:606-256-5191
Practice Address - Street 1:140 NEWCOMB AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:KY
Practice Address - Zip Code:40456-2728
Practice Address - Country:US
Practice Address - Phone:606-256-4148
Practice Address - Fax:606-256-5191
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY35006207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00082670OtherRAILROAD MEDICARE
KY000001179912OtherCHA
OHP00082670OtherRAILROAD MEDICARE
KY0102112OtherUNITED HEALTHCARE
KY163543300OtherDEPARTMENT OF LABOR
KY000000197553OtherANTHEM BC / BS
KY64035884Medicaid
KY0762002Medicare ID - Type Unspecified
KY0102112OtherUNITED HEALTHCARE