Healthcare Provider Details

I. General information

NPI: 1295654853
Provider Name (Legal Business Name): NICHOLAS DAVID STEWART
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 EASTMAN AVE
MIDLAND MI
48642-7817
US

IV. Provider business mailing address

1434 CRANBROOK DR
SAGINAW MI
48638-5469
US

V. Phone/Fax

Practice location:
  • Phone: 989-837-5310
  • Fax:
Mailing address:
  • Phone: 989-837-5310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302419012
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: