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Individual
MR. NOLAN PATRICK STEWART
Active
Individual
MR. NOLAN PATRICK STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205950
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487759957
ANTHEM
VA
05
—
1487759957
—
VA
Enumeration date
07/21/2009
Last updated
07/21/2009
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