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NPI Code Detail

MEDICARE: STEWARD MEDICAL GROUP, INC.

MEDICARE: STEWARD MEDICAL GROUP, INC.
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
12086S0129XVascular Surgery Physician
2208600000XSurgery Physician

Other Identifiers

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

General Provider Information

NPI Number : 1427621713
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEWARD MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : 9 GALEN ST
Second Line :
City : WATERTOWN
State : MA
Zip : 02472-4515
Country : US
Telephone Number : 617-562-5628
Fax Number :
Provider Business Practice Location Address
First Line : 7150 W 20TH AVE STE 615
Second Line :
City : HIALEAH
State : FL
Zip : 33016-5511
Country : US
Telephone Number : 305-820-6657
Fax Number :
Authorized Official
Title or Position : PROVIDER ENROLLMENT MANAGER
Name : AMY MARIE GUAY
Credential :
Telephone Number : 617-562-5628
Provider Enumeration Date : 07/23/2021
Last Update Date : 07/23/2021

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Directions to “STEWARD MEDICAL GROUP, INC. ” Practice Location

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