Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 40391 | CA |
NPI | 1013054188 |
---|---|
Provider Name | Dr. Matthew Bart Rowan |
First Address | Merced, CA 95348 |
Second Address | Merced, CA 95348-2731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |