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General NPI Number Information
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NPI Number | 1194762120
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Entity Type | Individual
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Provider Name | STEPHEN A CONWAY MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 01/03/2013
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Provider Practice Location Address
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Address Line | 33 BARTLETT ST SUITE 305
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City | LOWELL
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State | MA
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Zip | 01852-1334
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Country | US
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Telephone | 978-452-2200
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Fax | 978-441-2651
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Provider Business Mailing Address
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Address Line | 33 BARTLETT ST SUITE 305
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City | LOWELL
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State | MA
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Zip | 01852-1334
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Country | US
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Telephone | 978-452-2200
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Fax | 978-441-2651
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 11822
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License Number State | RI
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