Provider Demographics
NPI:1093804221
Name:GIL-STEWART, BEATRIZ ELENA (DO)
Entity Type:Individual
Prefix:DR
First Name:BEATRIZ
Middle Name:ELENA
Last Name:GIL-STEWART
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15579 WELLS HWY
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-1664
Mailing Address - Country:US
Mailing Address - Phone:864-882-7800
Mailing Address - Fax:864-882-5908
Practice Address - Street 1:15579 WELLS HWY
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1664
Practice Address - Country:US
Practice Address - Phone:864-882-7800
Practice Address - Fax:864-882-5908
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0674207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC006745Medicaid
SC006745Medicaid
SCH59173Medicare UPIN