Provider Demographics
NPI:1144756040
Name:STEWART, MICHELLE (R EEG/EPT)
Entity Type:Individual
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First Name:MICHELLE
Middle Name:
Last Name:STEWART
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Gender:F
Credentials:R EEG/EPT
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Mailing Address - Street 1:1880 BEAVER RIDGE CIR
Mailing Address - Street 2:SUITE D
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-3833
Mailing Address - Country:US
Mailing Address - Phone:888-329-0807
Mailing Address - Fax:844-272-5852
Practice Address - Street 1:1880 BEAVER RIDGE CIR
Practice Address - Street 2:SUITE D
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-3833
Practice Address - Country:US
Practice Address - Phone:888-329-0807
Practice Address - Fax:844-272-5852
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic