Individual
VICKI MIZUE STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
404 WESTWOOD AVE, SUITE 105, HIGH POINT, NC 27262-4315
(919) 882-6500
(919) 882-6501
Mailing address
PO BOX 16954, CHAPEL HILL, NC 27516-6954
(866) 497-8330
(919) 967-6647
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
38854
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80204
BLUE CROSS/BLUE SHIELD
NC
05
—
8980204
—
NC
Enumeration date
06/06/2006
Last updated
07/24/2007
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