Individual
SUSAN B STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1550 S POTOMAC ST, SUITE 155, AURORA, CO 80012
(303) 369-1020
Mailing address
1550 S POTOMAC ST, SUITE 155, AURORA, CO 80012
(303) 369-1020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14677TPG
CA
152W00000X
Optometrist
S798TA211
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009976235
—
AL
05
—
009976245
—
AL
01
—
051000468
BLUE CROSS OF ALABAMA
AL
01
—
051526309
BLUE CROSS OF ALABAMA
AL
01
—
P00160737
RAILROAD MEDICARE
AL
Enumeration date
04/08/2006
Last updated
01/26/2016
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