Stidham, Gregory

Stidham, Gregory is an individual health care provider with primary practice located at 1107A Brookdale St , Martinsville VA 24112-4501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Stidham, Gregory can be contacted via phone (276) 670-3300.

Contact Information

Primary practice address
1107A Brookdale St Martinsville VA 24112-4501
Phone: (276) 670-3300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101-037121 Virginia

Profile Details

NPI number 1487627378
LBN Legal business name Stidham, Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2006
Last updated Dec 7th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487627378 NPPES
Virginia MEDICAID 5637759
Virginia MEDICAID 5637767
Virginia MEDICAID 005632285

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