Healthcare Provider Details

I. General information

NPI: 1477533917
Provider Name (Legal Business Name): FRANK A STEWART D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15579 WELLS HIGHWAY
SENECA SC
29678-4318
US

IV. Provider business mailing address

200 WILDWOOD PLACE
SENECA SC
29672
US

V. Phone/Fax

Practice location:
  • Phone: 864-882-7800
  • Fax: 864-882-5908
Mailing address:
  • Phone: 864-654-3809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT0658
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: