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General NPI Number Information
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NPI Number | 1205113644
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Entity Type | Individual
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Provider Name | SANDRA LYNN STEWART RPH
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Gender | Female
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 3900 18 MILE RD
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City | STERLING HTS
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State | MI
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Zip | 48314-3826
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Country | US
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Telephone | 586-883-9131
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Fax | 586-883-9158
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Provider Business Mailing Address
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Address Line | 55310 SAINT PAUL DR
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City | MACOMB
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State | MI
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Zip | 48042-2414
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Country | US
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Telephone | 248-895-1254
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302028870
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License Number State | MI
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