Provider Demographics
NPI:1144599697
Name:GLOYD, STEPHEN STEWART (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:STEWART
Last Name:GLOYD
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 1:208 NW 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4336
Mailing Address - Country:US
Mailing Address - Phone:206-227-0165
Mailing Address - Fax:206-685-4184
Practice Address - Street 1:208 NW 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4336
Practice Address - Country:US
Practice Address - Phone:206-227-0165
Practice Address - Fax:206-685-4184
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00014073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine