Healthcare Provider Details

I. General information

NPI: 1770506735
Provider Name (Legal Business Name): MICHAEL OLIVER STUART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 N FOSTER DR
BATON ROUGE LA
70806-1818
US

IV. Provider business mailing address

1340 POYDRAS ST
NEW ORLEANS LA
70112-1221
US

V. Phone/Fax

Practice location:
  • Phone: 225-987-9000
  • Fax:
Mailing address:
  • Phone: 504-412-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.018875
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number18875
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: