Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | LL871 | SC |
N | 111NI0900X | Internist | LL871 | SC |
Y | 207RC0000X | Internist - Cardiovascular Disease | 871 | SC |
NPI | 1013094234 |
---|---|
Provider Name | Dr. Edward Allen Stewart |
First Address | Greenville, SC 29607-5261 |
Second Address | Greenville, SC 29607-5261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 17/08/2010 |