Individual
GREG STIVLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTL
Contact information
Practice address
3514 UNIVERSITY DR STE 8, DURHAM, NC 27707-2659
(919) 493-7002
(919) 403-1407
Mailing address
3514 UNIVERSITY DR STE 8, DURHAM, NC 27707-2659
(919) 493-7002
(919) 403-1407
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1757
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7379398
—
NC
01
—
79398
BCBS OF NC
NC
Enumeration date
03/02/2007
Last updated
07/09/2007
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