Individual
SUSAN STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 INTREPID AVE, PHILADELPHIA, PA 19112-1229
(360) 681-0129
Mailing address
1200 INTREPID AVE, PHILADELPHIA, PA 19112-1229
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
61286128
WA
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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