Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 639 | NC |
Y | 213ES0000X | Sports Medicine | 639 | NC |
NPI | 1053670786 |
---|---|
Provider Name | Dr. Titorya Stover |
First Address | Greensboro, NC 27405-3670 |
Second Address | Greensboro, NC 27405-5633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2012 |
Last Update Date | 25/08/2021 |