Individual
DR. JOHN EWING STIVELY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
JOHN STIVELY
Contact information
Practice address
200 MILL RD, FAIRHAVEN, MA 02719-5252
(508) 999-1100
Mailing address
57 BARNES ST, PROVIDENCE, RI 02906-1501
(401) 439-4950
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
59251
MA
207Q00000X
Family Medicine Physician
Primary
59251
MA
Other
Enumeration date
07/10/2006
Last updated
09/03/2014
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