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General NPI Number Information
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NPI Number | 1912500703
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Entity Type | Individual
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Provider Name | SAMUEL EVAN STEWART PHARMD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 104 HIGHWAY 72 W
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City | CORINTH
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State | MS
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Zip | 38834-5511
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Country | US
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Telephone | 662-287-8304
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Fax |
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Provider Business Mailing Address
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Address Line | 11 COUNTY ROAD 770
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City | WALNUT
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State | MS
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Zip | 38683-9262
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Country | US
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Telephone | 662-587-6199
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RPH029351
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | T-102057
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 49276
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License Number State | TN
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