Provider Demographics
NPI:1124087408
Name:ROWE, ANGELA W (DO)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:W
Last Name:ROWE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4472
Mailing Address - Country:US
Mailing Address - Phone:814-942-1166
Mailing Address - Fax:814-942-6222
Practice Address - Street 1:3000 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4472
Practice Address - Country:US
Practice Address - Phone:814-942-1166
Practice Address - Fax:814-942-6222
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010299L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017404390002Medicaid
PA0017404390002Medicaid
PA025107Medicare ID - Type Unspecified