Individual
CHARLES VINCENT STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6901 S OLYMPIA AVE, TULSA, OK 74132-1843
(918) 664-9892
(918) 664-2521
Mailing address
PO BOX 22063, DEPT 7175, TULSA, OK 74121-2063
(918) 664-9892
(918) 664-2521
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
16144
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100111050A
—
OK
05
—
200379180A
—
KS
Enumeration date
06/22/2005
Last updated
04/07/2010
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