Provider Demographics
NPI:1811043540
Name:DAVIS, STUART PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:PAUL
Last Name:DAVIS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:16 EASTBROOK BND
Mailing Address - Street 2:SUITE 202B
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1568
Mailing Address - Country:US
Mailing Address - Phone:770-486-8600
Mailing Address - Fax:770-486-8809
Practice Address - Street 1:16 EASTBROOK BND
Practice Address - Street 2:SUITE 202B
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1568
Practice Address - Country:US
Practice Address - Phone:770-486-8600
Practice Address - Fax:770-486-8809
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2010-10-07
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Provider Licenses
StateLicense IDTaxonomies
GA0465882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG12044Medicare UPIN