Individual
CRYSTAL STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6800
(248) 355-1402
Mailing address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(947) 262-8377
(248) 355-1402
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XYQM07771348
BCBS
MI
Enumeration date
06/21/2024
Last updated
06/21/2024
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