# ROWANSOM NMI ORTHOPEDICS SPORTS MED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548231517
- **Authorized official:** MICHAEL RIEKER (INTERIM CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (856) 770-5729

## Contact information

- **Practice address:** 42 E LAUREL RD, SUITE 1700, STRATFORD, NJ 08084-1354
- **Practice address phone:** (856) 566-7010
- **Practice address fax:** (856) 566-6956
- **Mailing address:** 42 E LAUREL RD, SUITE 1700, STRATFORD, NJ 08084-1354
- **Mailing address phone:** (856) 566-7010
- **Mailing address fax:** (856) 566-6956

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/30/2006
- **Last updated:** 05/03/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0431561000 | AMERIHEALTH | NJ |
| 05 | — | 3394107 | — | NJ |
| 01 | — | 42823 | AETNA | NJ |
| 01 | — | DD5957 | RAILROAD MEDICARE | NJ |