Provider Demographics
NPI:1114085941
Name:STUART, ANDRE ST CLAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:ST CLAIR
Last Name:STUART
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5559 MOUNTAIN VIEW PASS
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-6020
Mailing Address - Country:US
Mailing Address - Phone:770-413-2663
Mailing Address - Fax:770-413-0638
Practice Address - Street 1:34 UPPER RIVERDALE RD SE
Practice Address - Street 2:SUITE 100 A
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2635
Practice Address - Country:US
Practice Address - Phone:770-907-7222
Practice Address - Fax:770-991-3154
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA037707207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine