Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01029001A | IN |
NPI | 1134194459 |
---|---|
Provider Name | Kurt H Stiver |
First Address | South Bend, IN 46617-1924 |
Second Address | South Bend, IN 46601-1156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 25/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000085117 | ANTHEM BCBS (01) | IN |
000000195014 | ANTHEM BCBS (01) | IN |
000000239723 | ANTHEM BCBS (01) | IN |
100335380A | (05) | IN |
D95762 | (02) |