Provider Demographics
NPI:1457350068
Name:KATZ, STUART STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:STEPHEN
Last Name:KATZ
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 1:1140 HAMMOND DR NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5338
Mailing Address - Country:US
Mailing Address - Phone:404-851-5400
Mailing Address - Fax:404-851-5401
Practice Address - Street 1:1140 HAMMOND DR NE
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5338
Practice Address - Country:US
Practice Address - Phone:404-851-5400
Practice Address - Fax:404-851-5401
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018392207R00000X
GA18392207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000186821H ARMedicaid
GA511I060058Medicare PIN
GA000186821H ARMedicaid