MEDICARE: STUART J KNECHTLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204F00000X	Transplant Surgery Physician	30135	WI
2	204F00000X	Transplant Surgery Physician	061110	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013971670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STUART J KNECHTLE MD

Provider Business Mailing Address
First Line	:	5105 WMB
Second Line	:	101 WOODRUFF CIRCLE
City	:	ATLANTA
State	:	GA
Zip	:	30322-0001
Country	:	US
Telephone Number	:	404-712-7944
Fax Number	:	404-727-3660

Provider Business Practice Location Address
First Line	:	5105 WMB
Second Line	:	101 WOODRUFF CIRCLE
City	:	ATLANTA
State	:	GA
Zip	:	30322-0001
Country	:	US
Telephone Number	:	404-712-7944
Fax Number	:	404-727-3660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	11/19/2014

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