Provider Demographics
NPI:1851566434
Name:JENNINGS, STUART CLARK (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:CLARK
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:EASTERN NEPHROLOGY ASSOCIATES, PLLC
Mailing Address - Street 2:970 NEWMAN ROAD
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5200
Mailing Address - Country:US
Mailing Address - Phone:252-633-9262
Mailing Address - Fax:252-317-2094
Practice Address - Street 1:970 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5200
Practice Address - Country:US
Practice Address - Phone:252-633-9262
Practice Address - Fax:252-317-2094
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-00775207RN0300X
KY41618207RN0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist