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Individual

DR. MARK JAY STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2100 CENTRAL AVE STE 6, AUGUSTA, GA 30904-6709
(770) 929-9033
(706) 722-7454
Mailing address
3390 PEACHTREE RD NE STE 1500, ATLANTA, GA 30326-2822
(404) 920-4950

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
032058
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
032058
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
032058
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000413696E
GA
Enumeration date
10/27/2006
Last updated
04/09/2021
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