Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS8442 | FL |
N | 207QG0300X | Family Doctor - Geriatric Medicine | OS8442 | FL |
N | 208000000X | Pediatrician | OS8442 | FL |
NPI | 1306834817 |
---|---|
Provider Name | Stewart Foreman |
First Address | North Miami, FL 33161-5834 |
Second Address | North Miami, FL 33161-5832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 17/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
263258600 | (05) | FL |
D98585 | (02) | FL |