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Individual
TIMOTHY STUART
Active
Individual
TIMOTHY STUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
984
SC
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0512PA
—
SC
01
—
P00911625
RAILROAD MEDICARE
SC
01
—
SCE4916084
MEDICARE PIN
SC
01
—
SCE4916121
MEDICARE PIN
SC
Enumeration date
08/20/2008
Last updated
03/02/2020
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