Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 77666 | GA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 77666 | GA |
NPI | 1265728190 |
---|---|
Provider Name | Dr. Matthew Garrett Stewart |
First Address | Fortson, GA 31808-0370 |
Second Address | Columbus, GA 31909-3540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 20/11/2020 |