Individual
GIJSBERTUS F VANSTAVEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1236 HUFFMAN MILL RD, BURLINGTON, NC 27215-8700
(336) 585-1770
Mailing address
PO BOX 1832, BURLINGTON, NC 27216-1832
(336) 585-1770
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28934
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
28934
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8984718
—
NC
Enumeration date
01/17/2006
Last updated
12/19/2008
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