| Doctor Name: | LEE O STUART |
| NPI Number: | 1225147804 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 4301037582 |
| Business Practice Address: | 4294 Laurel Dr Lake Odessa, MI - 488498430 |
| Business Phone Number: | 6163747660 |
| Business Fax Number: | 6163740270 |
| Mailing Address: | 100 Michigan St Ne # Mc845, GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495032560 |
| Phone Number: | 6164866790 |
| Fax Number: | |
| NPI Enumeration Date: | 08/29/2006 |
| NPI Last Update Date: | 01/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301037582 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |