Provider Demographics
NPI:1275627481
Name:STUART, KAREN A (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:STUART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 18TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1724
Mailing Address - Country:US
Mailing Address - Phone:706-322-4950
Mailing Address - Fax:706-322-5614
Practice Address - Street 1:1201 18TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1724
Practice Address - Country:US
Practice Address - Phone:706-322-4950
Practice Address - Fax:706-322-5614
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030223207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP629Medicare ID - Type Unspecified
GAC75045Medicare UPIN