Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 264493 | MA |
N | 111NI0900X | Internist | 264493 | MA |
NPI | 1003298860 |
---|---|
Provider Name | Dominique Rowcroft |
First Address | Lewiston, ME 04241-1849 |
Second Address | Worcester, MA 01608-1216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2015 |
Last Update Date | 26/05/2021 |