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General NPI Number Information
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NPI Number | 1366456725
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Entity Type | Individual
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Provider Name | STEPHEN PAUL COWEN DO
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 6500 TABOR RD BLDG 2ND
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City | PHILADELPHIA
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State | PA
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Zip | 19111-5332
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Country | US
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Telephone | 215-697-8500
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Fax | 215-697-8502
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Provider Business Mailing Address
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Address Line | 3500 N BROAD ST RM 1A
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City | PHILADELPHIA
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State | PA
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Zip | 19140-4106
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Country | US
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Telephone | 215-926-9019
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0S003245L
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License Number State | PA
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