Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 056221 | OH |
NPI | 1134451750 |
---|---|
Provider Name | Kimberly A Stewart |
First Address | Fairlawn, OH 44333-4208 |
Second Address | Fairlawn, OH 44333-4208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2010 |
Last Update Date | 12/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3140381 | (05) | OH |