MEDICARE: DR. MICHAEL T. STEWART MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD0000030420	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	080182482	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3157601	OTHER	TN	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0101189	OTHER		UNITED HEALTHCARE

General Provider Information

NPI Number	:	1184611493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL T. STEWART MD

Provider Business Mailing Address
First Line	:	1514 SPARTA ST
Second Line	:
City	:	MC MINNVILLE
State	:	TN
Zip	:	37110-1317
Country	:	US
Telephone Number	:	931-473-8400
Fax Number	:	931-473-0620

Provider Business Practice Location Address
First Line	:	1514 SPARTA ST
Second Line	:
City	:	MC MINNVILLE
State	:	TN
Zip	:	37110-1317
Country	:	US
Telephone Number	:	931-473-8400
Fax Number	:	931-473-0620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	11/10/2020

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