Provider Demographics
NPI:1275538795
Name:STEWART, GEORGE EDWARD II (MD)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:EDWARD
Last Name:STEWART
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 SE 18TH ST
Mailing Address - Street 2:STE. 1002
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5408
Mailing Address - Country:US
Mailing Address - Phone:352-622-1126
Mailing Address - Fax:352-622-2391
Practice Address - Street 1:1740 SE 18TH ST
Practice Address - Street 2:SUITE 1002
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5408
Practice Address - Country:US
Practice Address - Phone:352-622-1126
Practice Address - Fax:352-622-2391
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME60635207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F76248Medicare UPIN
23955ZMedicare PIN
FL23955ZMedicare PIN