Provider Demographics
NPI:1740875194
Name:COWAN, STEVEN FORREST (MED)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:FORREST
Last Name:COWAN
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SAINT ANDREWS CT
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-6777
Mailing Address - Country:US
Mailing Address - Phone:912-554-5858
Mailing Address - Fax:
Practice Address - Street 1:14 SAINT ANDREWS CT
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-6777
Practice Address - Country:US
Practice Address - Phone:912-554-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health