Individual
DON OWEN STOVALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Mailing address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
19225
SC
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
19225
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326287434
MEDICAID DME NPI
SC
01
—
20076508
SELECT HEALTH DME
SC
05
—
T31766
—
SC
Enumeration date
06/30/2006
Last updated
03/11/2020
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