Individual
MICHAEL GORDON STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, CCC-A
Contact information
Practice address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Mailing address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000250
MI
237600000X
Audiologist-Hearing Aid Fitter
1601000250
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00719898
ASHA NUMBER
MI
01
—
1601000250
STATE LICENSE
MI
05
—
40-4683793
—
MI
01
—
640C32605
BCBS PIN
MI
05
—
90-2628470
—
MI
Enumeration date
10/18/2006
Last updated
05/01/2013
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