1548245244 NPI number — DR. CHRISTAN STEWART M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548245244 NPI number — DR. CHRISTAN STEWART M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

STEWART

Provider First Name:

CHRISTAN

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

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:

1548245244

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

01/22/2014

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1613 KAMER DR

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LA GRANGE

Provider Business Mailing Address State Name:

KY

Provider Business Mailing Address Postal Code:

40031-8601

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

502-802-5984

Provider Business Mailing Address Fax Number:

502-732-8553

Provider First Line Business Practice Location Address:

1911 HWY 227

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

CARROLLTON

Provider Business Practice Location Address State Name:

KY

Provider Business Practice Location Address Postal Code:

41008-8037

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

502-287-6725

Provider Business Practice Location Address Fax Number:

502-732-8553

Provider Enumeration Date:

12/14/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  32540 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 200863970 . This is a "ANTHEM IN MCD- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 200863970 . This is a "MD WISE- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 200863970 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 2838686000 . This is a "PASSADVANTAGE FOR NCMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 64325400 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
• Identifier: 000000507551 . This is a "ANTHEM FOR NCMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 110197852 . This is a "RRMCR FOR NCMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 000023026E . This is a "HUMANA- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 1879062 . This is a "CIGNA- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 089392 . This is a "SIHO- NORTON" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
• Identifier: 50014610 . This is a "PASSPORT FOR NCMA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".