Individual
MR. JIMMY LEE STEWART JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
16401
MS
208000000X
Pediatrics Physician
16401
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121927
—
MS
05
—
1133515
—
LA
01
—
P00393117
RR MEDICARE - GROUP CN0867
MS
Enumeration date
06/22/2006
Last updated
04/09/2014
Update your record
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