1407818313 NPI number — MARIAN BARRAUD STEWART MD

Table of content: MARIAN BARRAUD STEWART MD (NPI 1407818313)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407818313 NPI number — MARIAN BARRAUD STEWART MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEWART
Provider First Name:
MARIAN
Provider Middle Name:
BARRAUD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407818313
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
14088 ALABAMA STREET
Provider Business Mailing Address City Name:
JAY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32565-1036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-675-4546
Provider Business Mailing Address Fax Number:
850-675-4548

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14088 ALABAMA STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32565-1036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-675-4546
Provider Business Practice Location Address Fax Number:
850-675-4548
Provider Enumeration Date:
04/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  ME68044 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 051359 . This is a "VISTA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 32119 . This is a "PREFERRED PATIENT CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 32119 . This is a "BLUE CROSS AND BLUE SHIELD OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5173714 . This is a "AETNA CONTAINER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541009001 . This is a "ALACAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 009905570 . This is a "ALACAID" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1206338 . This is a "AARP HEALTHCARE UNITED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 160274001 . This is a "TEXAS MEDICAID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: Q68044 . This is a "DEPARTMENT OF PHYS SE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32119 . This is a "HEALTH 1ST NETWORK" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5173714 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5173714 . This is a "AETNA GLOBAL BENEFITS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 541900103 . This is a "ALACAID" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 59176907 . This is a "BLUE CROSS AND BLUE SHIELD OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 660022100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 160461 . This is a "HEALTHEASE HEALTH 1ST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 59109002 . This is a "BLUE CROSS AND BLUE SHIELD OF ALABAMA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 32119 . This is a "HEALTH OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5173714 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 593216460 . This is a "CHILDRENS MEDICAL SECURIT" identifier . This identifiers is of the category "OTHER".




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