Healthcare Provider Details

I. General information

NPI: 1114922267
Provider Name (Legal Business Name): NANCY W STEAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY WHITE

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 02/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1848 BLUE RIDGE DR NE
GAINESVILLE GA
30501-1210
US

IV. Provider business mailing address

1848 BLUE RIDGE DR NE
GAINESVILLE GA
30501-1210
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-9864
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number23233
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: