Mary Wassell Stowe, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

9400152 Issued in NC

Practice address

3030 Randolph Rd
Suite 200, MMG Museum
Charlotte, NC 28211-1368

Phone

(704) 302-8200

Fax

(704) 302-8201

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1861418162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601643",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601643",
            "telephone_number": "704-302-8200",
            "fax_number": "704-302-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 RANDOLPH RD",
            "address_2": "SUITE 200, MMG MUSEUM",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111368",
            "telephone_number": "704-302-8200",
            "fax_number": "704-302-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOWE",
        "first_name": "MARY",
        "middle_name": "WASSELL",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "56501",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9400152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00152",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861418162",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8980209",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Diane Stover
• Teantie Stover, PEER SUPPORT
• Claudia Littlejohn Stowe, CADC
• Kyarr Stowe
• Lachica Meshawn Stowe, LCSW-A
• Michelle Marie Stowe, M.D.
• Sheba Stowe, LPC
• Ainsley Strader
• Shardei Stradford
• Brian Steven Strahine

• Internal Medicine Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.