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Individual

DR. JACQUELINE K GIVIDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01060188A
IN
207L00000X
Anesthesiology Physician
Primary
2020-04712
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000361232
UNICARE
IN
01
000000361232
ANTHEM
KY
01
129703800
BLACK LUNG PROGRAM
IN
01
134960H
UNICARE MEDICARE
IN
01
200512950
MDWISE HOOSIER ALLIANCE
IN
05
200512950
IN
01
2684317000
PASSPORT ADVANTAGE
IN
01
50009617
PASSPORT
05
7100082610
KY
01
P00265884
RAILROAD MEDICARE
IN
Enumeration date
02/21/2006
Last updated
01/06/2021
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