MEDICARE: STUART K TODD 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	208600000X	Surgery Physician	19554	NC
2	2086S0129X	Vascular Surgery Physician	19554	NC

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	:	1588658314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STUART K TODD MD

Provider Business Mailing Address
First Line	:	1508 JEREMY LN
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27803-1518
Country	:	US
Telephone Number	:	252-443-4361
Fax Number	:	252-443-0096

Provider Business Practice Location Address
First Line	:	1508 JEREMY LN
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27803-1518
Country	:	US
Telephone Number	:	252-443-4361
Fax Number	:	252-443-0096

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

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	08/27/2007

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Directions to “ STUART K TODD MD” Practice Location

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