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General NPI Number Information
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NPI Number | 1891788600
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Entity Type | Individual
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Provider Name | STEVEN W. OWEIDA
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Gender | Male
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 61 WHITCHER STREET NE SUITE 2100
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City | MARIETTA
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State | GA
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Zip | 30060
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Country | US
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Telephone | 770-423-0595
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Fax | 770-874-1614
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Provider Business Mailing Address
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Address Line | 100 STONEFOREST DR STE 130
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City | WOODSTOCK
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State | GA
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Zip | 30189-4881
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Country | US
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Telephone | 770-423-0595
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Fax | 770-388-1627
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 026907
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License Number State | GA
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