Provider Demographics
NPI:1316933948
Name:STUART, SCOTT P (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:P
Last Name:STUART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5925
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-0891
Mailing Address - Country:US
Mailing Address - Phone:319-321-9998
Mailing Address - Fax:319-626-2856
Practice Address - Street 1:585 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9797
Practice Address - Country:US
Practice Address - Phone:319-569-8085
Practice Address - Fax:319-626-2856
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA281322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0040881Medicaid
IA04088OtherWELLMARK BCBS
IA04088OtherWELLMARK BCBS
IA04088Medicare PIN