Individual
STEPHEN GREGORY TRUESDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
405 W 15TH ST, 201, WASHINGTON, NC 27889-3524
(252) 940-1203
(252) 940-1206
Mailing address
4153 HEARTHSIDE DR, WILMINGTON, NC 28412
(919) 995-9491
(919) 995-9491
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
224P00000X
Prosthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0482P
BCBS
NC
05
—
7795069
—
NC
Enumeration date
01/16/2007
Last updated
10/28/2014
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