Provider Demographics
NPI:1750355731
Name:STUART, WILLIAM HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:STUART
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 1:3200 DOWNWOOD CIRCLE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:404-351-0205
Mailing Address - Fax:404-350-9823
Practice Address - Street 1:3200 DOWNWOOD CIR NW
Practice Address - Street 2:SUITE 550
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1610
Practice Address - Country:US
Practice Address - Phone:404-351-0205
Practice Address - Fax:404-351-4187
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012645174400000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
D41188Medicare UPIN
GA93BDGGQMedicare ID - Type Unspecified
GAD41188Medicare UPIN