Provider Demographics
NPI:1447293584
Name:STEWART, JOEL M JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:M
Last Name:STEWART
Suffix:JR
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:JOEL
Other - Middle Name:M
Other - Last Name:STEWART
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:157 CLINIC AVE STE 302A
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4454
Mailing Address - Country:US
Mailing Address - Phone:770-834-6302
Mailing Address - Fax:770-834-7660
Practice Address - Street 1:157 CLINIC AVE STE 302A
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4454
Practice Address - Country:US
Practice Address - Phone:770-834-6302
Practice Address - Fax:770-834-7660
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA673382082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
I57381OtherBLUE CROSS OF ALABAMA UP
AL009941756Medicaid
AL051539652OtherMEDICARE PROVIDER NUMBER