Individual
LAUREN STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 CANTERBURY DR, WRENS, GA 30833-4072
(706) 547-6409
Mailing address
400 CANTERBURY DR, WRENS, GA 30833-4072
(706) 547-6409
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
7099
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003144518A
—
GA
Enumeration date
02/07/2014
Last updated
11/17/2021
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