Provider Demographics
NPI:1518057454
Name:STOVER, BRIAN S (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:S
Last Name:STOVER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 5TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4206
Mailing Address - Country:US
Mailing Address - Phone:828-697-1343
Mailing Address - Fax:828-697-3224
Practice Address - Street 1:600 5TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4206
Practice Address - Country:US
Practice Address - Phone:828-697-1343
Practice Address - Fax:828-697-3224
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC551213EP1101X, 213ES0131X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00916626OtherMEDICARE RR
NC156U0OtherBCBS OF NC
NC5913946Medicaid
NC5913946Medicaid
VA020299F35Medicare PIN