Individual
GLEN D ROWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3601 SW 160TH AVE, SUITE 250, MIRAMAR, FL 33027-6308
(877) 866-7123
(855) 855-2792
Mailing address
640 S STATE ST, 742 BUILDING, DOVER, DE 19901-3530
(302) 674-3970
(302) 672-2350
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2015-00314
NC
207X00000X
Orthopaedic Surgery Physician
C20003481
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000217703
—
DE
01
—
000G32ZA5H
MEDICARE GROUP MEMBER PTAN
DE
Enumeration date
07/06/2005
Last updated
09/30/2015
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