1881699676 NPI number — DANIEL M STEWART DO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881699676 NPI number — DANIEL M STEWART DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEWART
Provider First Name:
DANIEL
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

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:
1881699676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43900 GARFIELD RD
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
CLINTON TOWNSHIP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48038-1137
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-286-2544
Provider Business Mailing Address Fax Number:
586-286-0534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
43900 GARFIELD RD
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
CLINTON TOWNSHIP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48038-1137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-286-2544
Provider Business Practice Location Address Fax Number:
586-286-0534
Provider Enumeration Date:
06/17/2005

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: 207N00000X , with the licence number:  5101006270 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1359481 . This is a "FIRST HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 87726 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 98999-2885 . This is a "SMART PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: C2720 . This is a "MCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60305 . This is a "AMERICAN COMMUNITY" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: E25752 . This is a "HAP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 98999-2816 . This is a "ABS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 38224 . This is a "ALLIANCE HEALTH AND LIFE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 62308 . This is a "CIGNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 95266 . This is a "BEAUMONT HBSDB" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 98999-0936 . This is a "CHAMPUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 131448 . This is a "PREFERRED CHOICES" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 37602 . This is a "GOLDEN RULE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 80705 . This is a "GREAT WEST" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 98999-2669 . This is a "DMC" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 98999-M116 . This is a "PPOM" identifier . This identifiers is of the category "OTHER".
  • Identifier: DS06270 . This is a "BCBSM OTHER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60054 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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