Provider Demographics
NPI:1992182489
Name:MOWERY, STEPHEN FREDERICK (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:FREDERICK
Last Name:MOWERY
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:UNR MED RESIDENCY PROGRAM
Mailing Address - Street 2:745 W. MOANA LANE
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:80509
Mailing Address - Country:US
Mailing Address - Phone:814-421-3546
Mailing Address - Fax:
Practice Address - Street 1:NAVAL MEDICAL CTR
Practice Address - Street 2:6195325998
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-3300
Practice Address - Country:US
Practice Address - Phone:619-532-5998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAVAD0000Medicare UPIN