Healthcare Provider Details

I. General information

NPI: 1164959250
Provider Name (Legal Business Name): MARIAH CLOUD STEWART MS, RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2017
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7191 CAHABA VALLEY RD
BIRMINGHAM AL
35242-6443
US

IV. Provider business mailing address

3487 TAL WOOD DR
HOOVER AL
35216-5233
US

V. Phone/Fax

Practice location:
  • Phone: 205-408-6550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number2415
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2415
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: