Individual
FERMIN V STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4045 JOHNS CREEK PKWY, SUITE C, SUWANEE, GA 30024-1253
(770) 495-7116
(770) 495-9410
Mailing address
4045 JOHNS CREEK PKWY, SUITE C, JOHNS CREEK, GA 30024-1217
(770) 495-7116
(770) 495-9410
Taxonomy
Speciality
Code
Description
License number
State
207YX0901X
Otology & Neurotology Physician
Primary
042452
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000710113D
—
GA
01
—
040017870
MEDICARE RAILROAD
GA
01
—
04BDCHM
MEDICARE ID
GA
01
—
5185463
AETNA
GA
01
—
582630847
BEECHSTREET
GA
Enumeration date
02/22/2006
Last updated
12/08/2010
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