Provider Demographics
NPI:1982672465
Name:STOWELL, CHRISTIAN R D (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:R D
Last Name:STOWELL
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:PO BOX 24410
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-0451
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1232 UNIVERSITY OF OREGON
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403-1205
Practice Address - Country:US
Practice Address - Phone:541-346-0565
Practice Address - Fax:541-346-2748
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD21238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR276624Medicaid
G35074Medicare UPIN
ORR114690Medicare PIN
OR276624Medicaid