Healthcare Provider Details

I. General information

NPI: 1275538795
Provider Name (Legal Business Name): GEORGE EDWARD STEWART II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 SE 18TH ST SUITE 1002
OCALA FL
34471-5408
US

IV. Provider business mailing address

1740 SE 18TH ST STE. 1002
OCALA FL
34471-5408
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-1126
  • Fax: 352-622-2391
Mailing address:
  • Phone: 352-622-1126
  • Fax: 352-622-2391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME60635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: