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Organization

STEWARD MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY KOCH (CFO)
(617) 562-5359
Entity
Organization

Contact information

Practice address
1317 W POINT DR, COCOA, FL 32922-6464
(615) 467-4158
(615) 467-1267
Mailing address
9 GALEN ST, WATERTOWN, MA 02472-4515
(617) 562-5359

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207RC0000X
Cardiovascular Disease Physician
207RI0011X
Interventional Cardiology Physician
207RP1001X
Pulmonary Disease Physician
207V00000X
Obstetrics & Gynecology Physician
208600000X
Surgery Physician
208800000X
Urology Physician
Primary

Other

Enumeration date
03/16/2017
Last updated
08/13/2020
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