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General NPI Number Information
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NPI Number | 1831195155
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Entity Type | Individual
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Provider Name | CHARLES VINCENT STEWART M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 04/07/2010
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Provider Practice Location Address
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Address Line | 6901 S OLYMPIA AVE
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City | TULSA
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State | OK
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Zip | 74132-1843
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Country | US
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Telephone | 918-664-9892
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Fax | 918-664-2521
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Provider Business Mailing Address
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Address Line | PO BOX 22063 DEPT 7175
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City | TULSA
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State | OK
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Zip | 74121-2063
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Country | US
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Telephone | 918-664-9892
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Fax | 918-664-2521
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 16144
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License Number State | OK
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