Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 69970 | GA |
NPI | 1023219672 |
---|---|
Provider Name | Eric C. Stiefel |
First Address | Valdosta, GA 31602-6418 |
Second Address | Valdosta, GA 31602-6418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 11/07/2013 |