| Doctor Name: | FALLON STEWART |
| NPI Number: | 1003099052 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PNP |
| License Number: | 226921 |
| Business Practice Address: | 6 Executive Park Dr Ne Suite 10 Atlanta, GA - 303292221 |
| Business Phone Number: | 4043219900 |
| Business Fax Number: | 4043214460 |
| Mailing Address: | 6 Executive Park Dr Ne, Suite 10 ATLANTA |
| State: | GA |
| Postal Code: | 303292221 |
| Phone Number: | 4043219900 |
| Fax Number: | 4043214460 |
| NPI Enumeration Date: | 12/13/2007 |
| NPI Last Update Date: | 03/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 226921 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |