Provider Demographics
NPI:1548251572
Name:STUART, DOUGLAS S (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:S
Last Name:STUART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3200 DOWNWOOD CIR NW
Mailing Address - Street 2:STE 550
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1610
Mailing Address - Country:US
Mailing Address - Phone:404-351-0205
Mailing Address - Fax:404-351-4187
Practice Address - Street 1:3200 DOWNWOOD CIR NW
Practice Address - Street 2:STE 550
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1610
Practice Address - Country:US
Practice Address - Phone:404-351-0205
Practice Address - Fax:404-351-4187
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0.55272084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00509506FMedicaid
GA212I135613Medicare PIN
GAF35073Medicare UPIN
GA13BDCHLMedicare PIN
GA00509506FMedicaid
GA13BDDRRMedicare PIN