| Doctor Name: | DR. STEPHEN JOSEPH MEDAWAR |
| NPI Number: | 1073598603 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | E2619 |
| Business Practice Address: | 7551 Madison Ave Citrus Heights, CA - 956107449 |
| Business Phone Number: | 9169043000 |
| Business Fax Number: | |
| Mailing Address: | 7551 Madison Avenue, CITRUS HEIGHTS |
| State: | CA |
| Postal Code: | 956103144 |
| Phone Number: | 9169043000 |
| Fax Number: | |
| NPI Enumeration Date: | 12/06/2005 |
| NPI Last Update Date: | 12/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | E2619 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |