Healthcare Provider Details

I. General information

NPI: 1831655893
Provider Name (Legal Business Name): STEVEN MCDOWELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 BROZZINI CT STE A-D
GREENVILLE SC
29615-5340
US

IV. Provider business mailing address

305 COUNTRY JUNCTION RD
WEST UNION SC
29696-3303
US

V. Phone/Fax

Practice location:
  • Phone: 864-288-7636
  • Fax:
Mailing address:
  • Phone: 808-651-1718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: