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Individual

DANITA A. STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
288 HIGHWAY 314, SUITE A, FAYETTEVILLE, GA 30214-7830
(770) 460-2131
(770) 460-5011
Mailing address
288 HIGHWAY 314, SUITE A, FAYETTEVILLE, GA 30214-7830
(770) 460-2131
(770) 460-5011

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
031136
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000543694C
GA
Enumeration date
07/06/2005
Last updated
01/06/2015
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