Individual
DIANE MARIE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1615 MAHAN CENTER BLVD, TALLAHASSEE, FL 32308-5443
(850) 521-5753
(850) 521-5701
Mailing address
1607 SAINT JAMES CT, TALLAHASSEE, FL 32308-5352
(850) 521-5700
(850) 521-5701
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
051603
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051603
STATE LICENSE
GA
Enumeration date
05/15/2006
Last updated
09/01/2009
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