Provider Demographics
NPI:1033362587
Name:ADAMS, STEWART FRANK (CST,CFA)
Entity Type:Individual
Prefix:
First Name:STEWART
Middle Name:FRANK
Last Name:ADAMS
Suffix:
Gender:M
Credentials:CST,CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5490 NW COUNTY ROAD 146
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32053-1611
Mailing Address - Country:US
Mailing Address - Phone:386-938-4402
Mailing Address - Fax:
Practice Address - Street 1:5490 NW COUNTY ROAD 146
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:FL
Practice Address - Zip Code:32053-1611
Practice Address - Country:US
Practice Address - Phone:386-938-4402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA90343246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant