Healthcare Provider Details

I. General information

NPI: 1295771541
Provider Name (Legal Business Name): GARRICK COLIN STEWART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 TOLL GATE ROAD ASP BLDG
WARWICK RI
02886-2759
US

IV. Provider business mailing address

455 TOLL GATE ROAD PRC AND CREDENTIALING
WARWICK RI
02886-2759
US

V. Phone/Fax

Practice location:
  • Phone: 401-681-4996
  • Fax: 401-921-6569
Mailing address:
  • Phone: 401-273-0641
  • Fax: 401-273-2919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD14139
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number229892
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: