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NPI Code Detail

MEDICARE: STEPHEN BRUCE STUART MD

MEDICARE:   STEPHEN BRUCE STUART  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
1207RC0000XCardiovascular Disease Physician34286AZ
2207RS0012XSleep Medicine (Internal Medicine) Physician34286AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00249737OTHERAZRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194729004
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN BRUCE STUART MD
Provider Business Mailing Address
First Line : 804 AINSWORTH DR
Second Line : SUITE 102
City : PRESCOTT
State : AZ
Zip : 86301-1624
Country : US
Telephone Number : 928-776-0601
Fax Number : 928-776-0620
Provider Business Practice Location Address
First Line : 804 AINSWORTH DR
Second Line : SUITE 102
City : PRESCOTT
State : AZ
Zip : 86301-1624
Country : US
Telephone Number : 928-776-0601
Fax Number : 928-776-0620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 09/29/2021

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Directions to “ STEPHEN BRUCE STUART MD” Practice Location

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