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Individual

DR. MARIAN W STEWART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
10994 HISTORIC HIGHWAY 165 STE D, HOLLISTER, MO 65672-5606
(417) 239-0079
(417) 239-1228
Mailing address
PO BOX 8781, SPRINGFIELD, MO 65801-8781
(417) 339-5691
(417) 339-7335

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
101644
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21186039
BLUE SHIELD OF KC
MO
05
244744504
MO
01
431835078
TRICARE
MO
01
P00204814
RAILROAD MEDICARE
MO
Enumeration date
05/20/2006
Last updated
04/15/2013
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