Provider Demographics
NPI:1811986136
Name:ROWAN MEDICAL PRACTICE INC
Entity type:Organization
Organization Name:ROWAN MEDICAL PRACTICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-210-5000
Mailing Address - Street 1:308 E CENTERVIEW ST
Mailing Address - Street 2:
Mailing Address - City:CHINA GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28023-2553
Mailing Address - Country:US
Mailing Address - Phone:704-855-2400
Mailing Address - Fax:704-857-1836
Practice Address - Street 1:308 E CENTERVIEW ST
Practice Address - Street 2:
Practice Address - City:CHINA GROVE
Practice Address - State:NC
Practice Address - Zip Code:28023-2553
Practice Address - Country:US
Practice Address - Phone:704-855-2400
Practice Address - Fax:704-857-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC690171NMedicaid
NC690168VMedicaid
NC690168VMedicaid
2316398FMedicare ID - Type Unspecified