Individual
EDWARD LEE STUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 812-9666
Mailing address
231 ELMBROOK LN, CANTON, GA 30114-7889
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN202438
GA
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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