Individual
DR. GREGORY A ROWDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3001 S CREASY LN STE 100A, LAFAYETTE, IN 47905-5206
(765) 420-5800
(765) 420-5801
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
01038394A
IN
208D00000X
General Practice Physician
010138394A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191311
ANTHEM BLUECROSS/BLUESHIE
—
05
—
100461040
—
IN
Enumeration date
10/05/2005
Last updated
09/18/2023
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