Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 03938 | KY |
NPI | 1922366061 |
---|---|
Provider Name | James Ryan Stewart |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40202-1837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2012 |
Last Update Date | 27/10/2020 |