Provider Demographics
NPI:1437249398
Name:STEWART, GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:STEWART
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 1:1430 TULANE AVE
Mailing Address - Street 2:DEPT. OF ORTHOPAEDICS, SL-32, ROOM 2070
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2699
Mailing Address - Country:US
Mailing Address - Phone:504-988-5770
Mailing Address - Fax:504-988-3517
Practice Address - Street 1:202 MCALISTER EXT
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5671
Practice Address - Country:US
Practice Address - Phone:504-864-1476
Practice Address - Fax:504-864-9914
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07570R207XX0005X
LAMD.07570R2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1399612Medicaid
LA1399612Medicaid
LAB91168Medicare UPIN