Provider Demographics
NPI:1336190834
Name:STEWART, JAMES R (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:STEWART
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Gender:M
Credentials:MD
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Mailing Address - Street 1:27901 WOODWARD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-0919
Mailing Address - Country:US
Mailing Address - Phone:248-545-0070
Mailing Address - Fax:248-545-4850
Practice Address - Street 1:27901 WOODWARD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-0919
Practice Address - Country:US
Practice Address - Phone:248-545-0070
Practice Address - Fax:248-545-4850
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2024-10-17
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Provider Licenses
StateLicense IDTaxonomies
MI4301034108207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1768387Medicaid
MIB42926Medicare UPIN
MI1768387Medicaid