Individual
PAUL WAYNE STEWARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1207 HILLTOP DR, LOWELL, IN 46356-2416
(219) 696-8190
Mailing address
1207 HILLTOP DR, LOWELL, IN 46356-2416
(219) 696-8190
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01020874A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02095A
MEDICAL LICENSE AUTHORIZATION CODE
IN
Enumeration date
04/20/2011
Last updated
04/20/2011
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