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Individual

AMANDA D STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-6482
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(985) 778-8592

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
302076
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04902578
MS
05
2429060
LA
Enumeration date
06/13/2016
Last updated
05/18/2021
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