Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 4301049356 | MI |
NPI | 1205877479 |
---|---|
Provider Name | Dr. Daniel Patrick Stewart |
First Address | Kalamazoo, MI 49007-4832 |
Second Address | Battle Creek, MI 49015-4155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 11/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10/2698732 | (05) | MI |
10/2750467 | (05) | MI |
10/4687059 | (05) | MI |
1205877479 | (05) | MI |
700C910950 | BCBSM (01) | MI |
E77936 | (02) | MI |