Provider Demographics
NPI:1356559082
Name:ABELOW, STEPHEN PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PAUL
Last Name:ABELOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2311 LAKE TAHOE BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-7129
Mailing Address - Country:US
Mailing Address - Phone:530-544-8033
Mailing Address - Fax:
Practice Address - Street 1:2311 LAKE TAHOE BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-7129
Practice Address - Country:US
Practice Address - Phone:530-544-8033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG38077207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine