Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PS598 | ME |
Y | 103T00000X | Psychologist | PS598 | ME |
NPI | 1003022617 |
---|---|
Provider Name | Dr. John Neal Stewart |
First Address | Portland, ME 04102-3212 |
Second Address | Portland, ME 04102-2015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |