Individual
DR. BRUCE ANDREW STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
370 N 120TH AVE, HOLLAND, MI 49424
(616) 396-5855
(616) 396-5720
Mailing address
370 N 120TH AVE, R, HOLLAND, MI 49424-2196
(616) 396-5855
(616) 396-5720
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301093528
MI
207X00000X
Orthopaedic Surgery Physician
M9678
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
4301093528
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073768917
—
MI
01
—
BS093528
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/19/2008
Last updated
05/30/2018
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