Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 07570R | LA |
Y | 2081S0010X | Sports Medicine | MD.07570R | LA |
Y | 213ES0000X | Sports Medicine | MD.07570R | LA |
NPI | 1437249398 |
---|---|
Provider Name | Dr. Gregory Stewart |
First Address | New Orleans, LA 70112-2699 |
Second Address | New Orleans, LA 70118-5671 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 09/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1399612 | (05) | LA |
B91168 | (02) | LA |