Provider Demographics
NPI:1003495185
Name:OWENS, STEVEN DOUGLASS
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DOUGLASS
Last Name:OWENS
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 1:140 LOZIER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-2522
Mailing Address - Country:US
Mailing Address - Phone:585-355-3249
Mailing Address - Fax:
Practice Address - Street 1:140 LOZIER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-2522
Practice Address - Country:US
Practice Address - Phone:585-355-3249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver