Provider Demographics
NPI:1629398219
Name:STEWARD MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:STEWARD MEDICAL GROUP, INC
Other - Org Name:STEWARD PHYSICIAN NETWORK, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OF STEWARD MEDICAL GROUP
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GUAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-341-8848
Mailing Address - Street 1:PO BOX 9657
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9657
Mailing Address - Country:US
Mailing Address - Phone:617-562-5359
Mailing Address - Fax:
Practice Address - Street 1:9 GALEN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4515
Practice Address - Country:US
Practice Address - Phone:615-467-4474
Practice Address - Fax:615-467-1267
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEWARD HEALTH CARE SYSTEM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-04
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty