Provider Demographics
NPI:1174618250
Name:ROWE, JULIAN F (MD)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:F
Last Name:ROWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950C OLD US 66
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:NM
Mailing Address - Zip Code:87015-6745
Mailing Address - Country:US
Mailing Address - Phone:505-884-8900
Mailing Address - Fax:505-806-7183
Practice Address - Street 1:6621 GULTON CT NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4407
Practice Address - Country:US
Practice Address - Phone:505-888-0443
Practice Address - Fax:505-888-1398
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM97136207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMS5901Medicaid
NMS5901Medicaid
$$$$$$$$$Medicare PIN