MEDICARE: MR. EUGENE STEWART JR.

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	253Z00000X	In Home Supportive Care Agency		DC

General Provider Information

NPI Number	:	1770245847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EUGENE STEWART JR.

Provider Business Mailing Address
First Line	:	812 JEFFERSON ST NW APT 209
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-2941
Country	:	US
Telephone Number	:	240-801-0118
Fax Number	:

Provider Business Practice Location Address
First Line	:	812 JEFFERSON ST NW APT 209
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-2941
Country	:	US
Telephone Number	:	240-801-0118
Fax Number	:

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

Provider Enumeration Date	:	10/06/2021
Last Update Date	:	10/06/2021

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