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Individual
MRS. MARTHA ANNE STEWART
Active
Individual
MRS. MARTHA ANNE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
52362
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA147934
MEDICARE PTAN
CA
Enumeration date
11/15/2006
Last updated
02/21/2017
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