Provider Demographics
NPI:1518962521
Name:STUART, DENNIS O'GAREY (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:O'GAREY
Last Name:STUART
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 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:725 OAKRIDGE BLVD STE B2
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-2351
Practice Address - Country:US
Practice Address - Phone:910-671-0052
Practice Address - Fax:910-671-9157
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC80693OtherBCBS
NC7980693Medicaid
NC7980693Medicaid
NC80693OtherBCBS
NCA15705Medicare UPIN
NC2191687EMedicare PIN