Provider Demographics
NPI:1720735418
Name:ROWE, TREY KENNETH (PA-C)
Entity Type:Individual
Prefix:
First Name:TREY
Middle Name:KENNETH
Last Name:ROWE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:TREY
Other - Middle Name:KENNETH
Other - Last Name:BARHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 KIMEL PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6185
Practice Address - Country:US
Practice Address - Phone:336-245-2100
Practice Address - Fax:336-768-7782
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-11487363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant