Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | D0053844 | MD |
N | 208600000X | Surgeon | D0053844 | MD |
Y | 2086S0120X | Pediatric Surgery | D53844 | MD |
NPI | 1134143498 |
---|---|
Provider Name | Dr. Fray Dylan Stewart |
First Address | Baltimore, MD 21287-0005 |
Second Address | Baltimore, MD 21287-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 13/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0103 | CAREFIRST (01) | MD |
061401700 | (05) | MD |
1701493 | UNITED HLTHCARE (01) | MD |
2138547 | MDIPA (01) | MD |
2210485 | UNITED HLTHCARE NATIONAL (01) | MD |
252812 | KAISER (01) | MD |
60645101 | BLUE SHIELD (01) | MD |
G98946 | (02) | MD |