MEDICARE: MR. STEVEN O. STEWART 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	207Q00000X	Family Medicine Physician	041369	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
2	52650560002	OTHER	GA	BC/BS PROVIDER ID
3	1049349	OTHER	GA	FIRST HEALTH
4	87726	OTHER	GA	UHC
5	2031561	OTHER	GA	AETNA PROVIDER NUMBER
6	05011	OTHER	GA	GEORGIA 1ST
7	3891011	OTHER	GA	CIGNA PROVIDER NUMBER

General Provider Information

NPI Number	:	1679579643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEVEN O. STEWART MD

Provider Business Mailing Address
First Line	:	4500 HUGH HOWELL RD
Second Line	:	STE 220
City	:	TUCKER
State	:	GA
Zip	:	30084
Country	:	US
Telephone Number	:	770-469-0668
Fax Number	:	770-469-0676

Provider Business Practice Location Address
First Line	:	4500 HUGH HOWELL RD
Second Line	:	STE 220
City	:	TUCKER
State	:	GA
Zip	:	30084
Country	:	US
Telephone Number	:	770-469-0668
Fax Number	:	770-469-0676

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	10/27/2011

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