Individual
JEREMIAH W STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(260) 969-1950
Mailing address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(260) 969-1950
(260) 918-2137
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10001038A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000594502
ANTHEM BC/BS
IN
01
—
000000625946
ANTHEM BC/BS
IN
01
—
000000659921
ANTHEM BC/BS
IN
01
—
P00712308
RAILROAD MEDICARE
IN
01
—
P00775323
RAILROAD MEDICARE
IN
01
—
P00841089
RAILROAD MEDICARE
IN
Enumeration date
09/09/2008
Last updated
03/05/2015
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