Provider Demographics
NPI:1235130378
Name:GARDNER, STUART WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:WILLIAM
Last Name:GARDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2 SUMMIT PL
Mailing Address - Street 2:SUITE 3-G
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4100
Mailing Address - Country:US
Mailing Address - Phone:203-481-3333
Mailing Address - Fax:203-481-7377
Practice Address - Street 1:2 SUMMIT PL
Practice Address - Street 2:SUITE 3-G
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-4100
Practice Address - Country:US
Practice Address - Phone:203-481-3333
Practice Address - Fax:203-481-7377
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT026254208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics