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General NPI Number Information
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NPI Number | 1073768917
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Entity Type | Individual
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Provider Name | BRUCE ANDREW STEWART M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 370 N 120TH AVE
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City | HOLLAND
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State | MI
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Zip | 49424
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Country | US
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Telephone | 616-396-5855
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Fax | 616-396-5720
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Provider Business Mailing Address
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Address Line | 370 N 120TH AVE R
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City | HOLLAND
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State | MI
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Zip | 49424-2196
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Country | US
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Telephone | 616-396-5855
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Fax | 616-396-5720
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | M9678
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 4301093528
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301093528
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License Number State | MI
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