Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301088705 | MI |
Y | 111NI0900X | Internist | 4301088705 | MI |
N | 207RR0500X | Rheumatology | 4301088705 | MI |
NPI | 1033386172 |
---|---|
Provider Name | Dr. Shironda Nakia Stewart |
First Address | Detroit, MI 48202-2739 |
Second Address | Detroit, MI 48202-2739 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 24/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0P41360 | (02) | MI |
1831433218 | CORPORATE NPI (01) | MI |
4301088705 | LICENSE (01) | MI |
453483650 | TAX ID (01) | MI |