Provider Demographics
NPI:1518053859
Name:CHOW, STELLA Y (MD)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:Y
Last Name:CHOW
Suffix:
Gender:F
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:ONE ESSEX CENTER DRIVE
Mailing Address - Street 2:LAHEY CLINIC NORTH
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2901
Mailing Address - Country:US
Mailing Address - Phone:978-538-4680
Mailing Address - Fax:978-538-4750
Practice Address - Street 1:ONE ESSEX CENTER DRIVE
Practice Address - Street 2:LAHEY CLINIC NORTH
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2901
Practice Address - Country:US
Practice Address - Phone:978-538-4680
Practice Address - Fax:978-538-4750
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA77700207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110057108AMedicaid
MAG26331Medicare UPIN
MAA2124401Medicare PIN