Individual
STEWART A FERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1251 W CEDAR LOOP, CHEROKEE, IA 51012-1566
(712) 225-2594
Mailing address
PO BOX 194, PETERSON, IA 51047-0194
(712) 295-7010
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
27400
IA
2084P0800X
Psychiatry Physician
35-06-2806F
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000328171
ANTHEM PIN
OH
01
—
108663000
MAGELLAN PIN
OH
05
—
2379706
—
OH
01
—
307823
TRICARE/MHN PIN
OH
01
—
7771497
AETNA PIN
OH
05
—
E47264
—
OH
01
—
Y108663
THE HEALTH PLAN PIN
OH
Enumeration date
03/21/2006
Last updated
02/26/2016
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