Healthcare Provider Details

I. General information

NPI: 1437249398
Provider Name (Legal Business Name): GREGORY STEWART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 MCALISTER EXT
NEW ORLEANS LA
70118-5671
US

IV. Provider business mailing address

1430 TULANE AVE DEPT. OF ORTHOPAEDICS, SL-32, ROOM 2070
NEW ORLEANS LA
70112-2699
US

V. Phone/Fax

Practice location:
  • Phone: 504-864-1476
  • Fax: 504-864-9914
Mailing address:
  • Phone: 504-988-5770
  • Fax: 504-988-3517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number07570R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD.07570R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: