Provider Demographics
NPI:1245222173
Name:SPRINGATE, STEPHEN CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:CHARLES
Last Name:SPRINGATE
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 1:2520 CHERRY AVE
Mailing Address - Street 2:S CHARLES SPRINGATE MD
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-4229
Mailing Address - Country:US
Mailing Address - Phone:360-475-8545
Mailing Address - Fax:360-475-8542
Practice Address - Street 1:2520 CHERRY AVE
Practice Address - Street 2:S CHARLES SPRINGATE MD
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-4229
Practice Address - Country:US
Practice Address - Phone:360-475-8545
Practice Address - Fax:360-475-8542
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000287002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1072636Medicaid
WA920000322OtherRR MEDICARE
WA920000322OtherRR MEDICARE
WAG000200682Medicare PIN