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General NPI Number Information
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NPI Number | 1205253408
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Entity Type | Individual
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Provider Name | DANE HADEN STEWART M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 04/04/2019
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Provider Practice Location Address
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Address Line | 1800 E PAVILION PL UNIT B
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City | MONTROSE
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State | CO
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Zip | 81401
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Country | US
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Telephone | 970-249-1210
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Fax | 970-249-3057
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Provider Business Mailing Address
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Address Line | 1800 E PAVILION PL UNIT B
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City | MONTROSE
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State | CO
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Zip | 81401-5499
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Country | US
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Telephone | 970-249-1210
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Fax | 970-249-3057
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MT207872
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | DR.0059786
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R74549
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License Number State | AZ
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