Healthcare Provider Details

I. General information

NPI: 1871818211
Provider Name (Legal Business Name): JAMES LOUIS STEWARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 QUEENS CHAPEL RD APT 13
MOUNT RAINIER MD
20712-1184
US

IV. Provider business mailing address

3001 QUEENS CHAPEL RD APT 13
MOUNT RAINIER MD
20712-1184
US

V. Phone/Fax

Practice location:
  • Phone: 301-779-9611
  • Fax:
Mailing address:
  • Phone: 301-779-9611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101231934
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: