Provider Demographics
NPI:1174051478
Name:STEWART, GREGORY DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DAVID
Last Name:STEWART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:888-472-0043
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:510 ALBEMARLE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7540
Practice Address - Country:US
Practice Address - Phone:843-723-6426
Practice Address - Fax:843-722-2193
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2025-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAOP61354417208600000X
SC93569208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery