Provider Demographics
NPI:1639193600
Name:STEWART, DAVID SA (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SA
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 1:6400 W NEWBERRY RD
Mailing Address - Street 2:SUITE # 207 MEDICAL ARTS BUILDING
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-6605
Mailing Address - Country:US
Mailing Address - Phone:352-371-2011
Mailing Address - Fax:352-384-3611
Practice Address - Street 1:6400 W NEWBERRY RD
Practice Address - Street 2:SUITE # 207 MEDICAL ARTS BUILDING
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-6605
Practice Address - Country:US
Practice Address - Phone:352-371-2011
Practice Address - Fax:352-384-3611
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61421207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL371576100Medicaid
FL17945UMedicare PIN
FL371576100Medicaid