Organization
DIBERT & NUTT MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN WESLEY DIBERT M.D. (PHYSICIAN)
(704) 864-5550
Entity
Organization
Contact information
Practice address
2555 COURT DR, SUITE 400, GASTONIA, NC 28054-2134
(704) 864-5550
(704) 864-7448
Mailing address
2555 COURT DR, SUITE 400, GASTONIA, NC 28054-2134
(704) 864-5550
(704) 864-7448
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22658
PARTNERS MEDICARE
NC
01
—
28459
BLUE CROSS BLUE SHIELD
NC
05
—
5902832
—
NC
05
—
8928459
—
NC
Enumeration date
05/22/2006
Last updated
08/22/2020
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