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Individual

CARLOS DEOAN STEWART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
640 AIKEN ST, AUGUSTA, GA 30901-2068
(706) 495-6966
Mailing address
640 AIKEN ST, AUGUSTA, GA 30901-2068

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN164032
GA

Other

Enumeration date
08/23/2007
Last updated
08/23/2007
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