Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101051571 | VA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0101051571 | VA |
NPI | 1093789430 |
---|---|
Provider Name | Dr. Joel D. Stewart |
First Address | Newport News, VA 23606-3074 |
Second Address | Newport News, VA 23606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 05/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MC10205 | (02) | VA |