Provider Demographics
NPI:1881623411
Name:STOWELL, STEVEN DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:STOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1675 E MAIN ST
Mailing Address - Street 2:BOX 328
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-5818
Mailing Address - Country:US
Mailing Address - Phone:330-677-3632
Mailing Address - Fax:330-677-8770
Practice Address - Street 1:1930 STATE ROUTE 59
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4112
Practice Address - Country:US
Practice Address - Phone:330-677-3632
Practice Address - Fax:330-677-8770
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0876082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH06743Medicare UPIN