=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053670786
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TITORYA STOVER DPM/MPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2012
-----------------------------------------------------
Last Update Date | 12/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 503 N FAYETTEVILLE ST
-----------------------------------------------------
City | ASHEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27203-4728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-626-2688
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 503 N FAYETTEVILLE ST
-----------------------------------------------------
City | ASHEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27203-4728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-626-2688
-----------------------------------------------------
Fax | 336-626-4100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0000X
-----------------------------------------------------
Taxonomy Name | Sports Medicine Podiatrist
-----------------------------------------------------
License Number | 639
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------