Provider Demographics
NPI:1063467124
Name:STOWE, STEPHEN PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PETER
Last Name:STOWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1350
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-1350
Mailing Address - Country:US
Mailing Address - Phone:704-799-3380
Mailing Address - Fax:704-799-6315
Practice Address - Street 1:603 EAST CENTER ST
Practice Address - Street 2:SUITE A
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2590
Practice Address - Country:US
Practice Address - Phone:704-663-5090
Practice Address - Fax:704-663-5502
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35525207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902214Medicaid
NC2176084BMedicare ID - Type Unspecified
NC5902214Medicaid