Individual
DENNIS A STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
369 N MAIN ST, CRESTVIEW, FL 32536-3541
(850) 689-3123
(850) 689-1633
Mailing address
369 N MAIN ST, CRESTVIEW, FL 32536-3541
(850) 689-3123
(850) 689-1633
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME59782
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053717900
—
FL
01
—
1508911843
GROUP NPI
—
01
—
K6357
MEDICARE GROUP PTAN
FL
Enumeration date
01/25/2007
Last updated
04/08/2015
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