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1174306757
PAUL CHRISTIAN STIVERSON
LAFAYETTE, IN
NPI
1174306757
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10004156A)
Enumeration Date
2023-08-16
Last Update Date
2023-10-26
Business Address
PAUL CHRISTIAN STIVERSON PA-C
1701 S CREASY LN
LAFAYETTE, IN 47905-4972
Phone number: 765-502-4000
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Mailing Address
PAUL CHRISTIAN STIVERSON PA-C
710 VETERANS MEMORIAL PKWY W APT 13
LAFAYETTE, IN 47909-6960
Phone number: 765-412-7371
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