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General NPI Number Information
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NPI Number | 1326203605
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Entity Type | Individual
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Provider Name | DANIEL MAXWELL STUART MD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2008
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 4510 EXECUTIVE DR STE 100
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City | SAN DIEGO
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State | CA
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Zip | 92121-3022
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Country | US
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Telephone | 858-275-2206
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 181888
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City | CORONADO
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State | CA
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Zip | 92178-1888
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Country | US
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Telephone | 858-275-2206
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | G48748
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License Number State | CA
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