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Individual

STACIE J NOBLE-SHRIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
ONE HOSPITAL ROAD, OAK BLUFFS, MA 02557
(508) 693-0410
Mailing address
ONE HOSPITAL ROAD, OAK BLUFFS, MA 02557
(508) 693-0410

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
202501
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0191612
MA
Enumeration date
07/07/2005
Last updated
07/08/2007
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