Provider Demographics
NPI:1487656930
Name:CAVALIERI, STUART A (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:A
Last Name:CAVALIERI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 FREEDOM WAY
Mailing Address - Street 2:CARDIOLOGY SECTION (251)
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6258
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-823-3911
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:CARDIOLOGY SECTION (251)
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-823-3911
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00037637207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8244659Medicaid
G34002Medicare UPIN
WA8244659Medicaid