Provider Demographics
NPI:1225079692
Name:STOVER, GARNETT EDWARD III (DC)
Entity Type:Individual
Prefix:DR
First Name:GARNETT
Middle Name:EDWARD
Last Name:STOVER
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6161 WINDING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-4585
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9097 ATLEE STATION RD
Practice Address - Street 2:SUITE 118
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2525
Practice Address - Country:US
Practice Address - Phone:804-559-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00177291OtherRAILROAD MEDICARE
VA3192711OtherAETNA PPO
VA7341062OtherALLIANCE/MAMSI
VA5578730OtherAETNA HMO
VA125565OtherSOUTHERN HEALTH
VA216663OtherANTHEM BC/BS
VA8879428OtherCIGNA
VA125565OtherSOUTHERN HEALTH
VA350000895Medicare ID - Type Unspecified