Provider Demographics
NPI:1295744316
Name:BAINE, STUART A (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:A
Last Name:BAINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5258 LINTON BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484
Mailing Address - Country:US
Mailing Address - Phone:561-495-0990
Mailing Address - Fax:561-495-8276
Practice Address - Street 1:5258 LINTON BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6540
Practice Address - Country:US
Practice Address - Phone:561-495-0990
Practice Address - Fax:561-495-8276
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME047893207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1851570543Medicare NSC
73265ZMedicare PIN