Provider Demographics
NPI:1639984131
Name:ROWLAND, CORNELIUS TIMOTHY
Entity type:Individual
Prefix:
First Name:CORNELIUS
Middle Name:TIMOTHY
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 BRYANT ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1021
Mailing Address - Country:US
Mailing Address - Phone:202-790-9598
Mailing Address - Fax:
Practice Address - Street 1:1400 FLORIDA AVE NE APT 104
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5297
Practice Address - Country:US
Practice Address - Phone:202-820-6685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant