Healthcare Provider Details

I. General information

NPI: 1336190834
Provider Name (Legal Business Name): JAMES R STEWART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27901 WOODWARD AVE SUITE 300
BERKLEY MI
48072-0919
US

IV. Provider business mailing address

27901 WOODWARD AVE SUITE 300
BERKLEY MI
48072-0919
US

V. Phone/Fax

Practice location:
  • Phone: 248-545-0070
  • Fax: 248-545-4850
Mailing address:
  • Phone: 248-545-0070
  • Fax: 248-545-4850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301034108
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: