Provider Demographics
NPI:1407210297
Name:SCRUGGS, STEWART (MD)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:
Last Name:SCRUGGS
Suffix:
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 1:3104 BLUE LAKE DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243
Mailing Address - Country:US
Mailing Address - Phone:205-977-1949
Mailing Address - Fax:205-977-1933
Practice Address - Street 1:1200 MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720
Practice Address - Country:US
Practice Address - Phone:205-977-1949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMD.86521207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology