Individual
MRS. MARY WASSELL STOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3030 RANDOLPH RD, SUITE 200, MMG MUSEUM, CHARLOTTE, NC 28211-1368
(704) 302-8200
(704) 302-8201
Mailing address
PO BOX 601643, CHARLOTTE, NC 28260-1643
(704) 302-8200
(704) 302-8201
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
56501
NC
207R00000X
Internal Medicine Physician
Primary
9400152
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861418162
—
NC
05
—
8980209
—
NC
05
—
N00152
—
SC
Enumeration date
07/14/2006
Last updated
09/24/2018
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