Individual
DR. LARRY LEE STOVER II
Active
Individual
DR. LARRY LEE STOVER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01064277A
IN
2085R0202X
Diagnostic Radiology Physician
11013299A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201025640
—
IN
01
—
P00995173
RAILROAD MEDICARE
IN
Enumeration date
06/20/2007
Last updated
10/03/2016
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