Provider Demographics
NPI:1952489825
Name:ROWE, DOUGLAS S (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:S
Last Name:ROWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5899 BREMO RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1935
Mailing Address - Country:US
Mailing Address - Phone:804-285-4115
Mailing Address - Fax:804-673-6714
Practice Address - Street 1:5899 BREMO RD
Practice Address - Street 2:SUITE 205
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1935
Practice Address - Country:US
Practice Address - Phone:804-285-4115
Practice Address - Fax:804-673-6714
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010186942086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006900798Medicaid
VA240000262Medicare ID - Type UnspecifiedC03698
VAC36712Medicare UPIN