MEDICARE: BRETT STEWART PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	002314	IA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01134148	OTHER	IA	RR MEDICARE

General Provider Information

NPI Number	:	1639434046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT STEWART PA

Provider Business Mailing Address
First Line	:	6000 UNIVERSITY AVE STE 101
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8201
Country	:	US
Telephone Number	:	515-241-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 UNIVERSITY AVE STE 101
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-8201
Country	:	US
Telephone Number	:	515-241-2600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2012
Last Update Date	:	03/14/2014

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Directions to “ BRETT STEWART PA” Practice Location

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