Provider Demographics
NPI:1477533917
Name:STEWART, FRANK A (DO)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:STEWART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WILDWOOD PLACE
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29672
Mailing Address - Country:US
Mailing Address - Phone:864-654-3809
Mailing Address - Fax:
Practice Address - Street 1:15579 WELLS HIGHWAY
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-4318
Practice Address - Country:US
Practice Address - Phone:864-882-7800
Practice Address - Fax:864-882-5908
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCT0658208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT00727Medicaid