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General NPI Number Information
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NPI Number | 1801468251
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Entity Type | Organization
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Legal Business Name | STEWARD MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 3540 N PINE ISLAND RD
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City | SUNRISE
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State | FL
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Zip | 33351-6637
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Country | US
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Telephone | 954-321-1776
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Fax |
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Provider Business Mailing Address
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Address Line | 9 GALEN ST
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City | WATERTOWN
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State | MA
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Zip | 02472-4515
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Country | US
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Telephone | 617-562-5628
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OF STEWARD MEDICAL GROUP
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Name | AMY MARIE GUAY
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Credential |
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Telephone | 617-562-5628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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