Individual
DEREK STEWART JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1614 E MAIN ST STE D, NEW IBERIA, LA 70560-4056
(337) 256-5917
Mailing address
1614 E MAIN ST STE D, NEW IBERIA, LA 70560-4056
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467745000
NPI
LA
Enumeration date
05/13/2016
Last updated
02/03/2020
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