Provider Demographics
NPI:1720120470
Name:STUART, CAROLE MAXWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:MAXWELL
Last Name:STUART
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3635 STIMPSON DR
Mailing Address - Street 2:
Mailing Address - City:PFAFFTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27040-8610
Mailing Address - Country:US
Mailing Address - Phone:336-924-6131
Mailing Address - Fax:336-922-1216
Practice Address - Street 1:LOWER LEVEL REYNOLDS GYM-WINGATE RD.
Practice Address - Street 2:WINGATE RD.
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27109
Practice Address - Country:US
Practice Address - Phone:336-758-5218
Practice Address - Fax:336-758-6054
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC17287207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCAS4545046OtherDEA NUMBER