Provider Demographics
NPI:1427070812
Name:KERNES, STEWART M (DO)
Entity type:Individual
Prefix:
First Name:STEWART
Middle Name:M
Last Name:KERNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1670 E FLAMINGO RD STE C
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5120
Mailing Address - Country:US
Mailing Address - Phone:702-892-0660
Mailing Address - Fax:702-650-0549
Practice Address - Street 1:1670 E FLAMINGO RD STE C
Practice Address - Street 2:SUITE C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5120
Practice Address - Country:US
Practice Address - Phone:702-892-0660
Practice Address - Fax:702-650-0549
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVTL1015207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIE46194Medicare UPIN