MEDICARE: MRS. SYLVIA H STEWART

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1245638113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SYLVIA H STEWART

Provider Business Mailing Address
First Line	:	4000 FABER PLACE DR
Second Line	:	SUITE 327
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-8585
Country	:	US
Telephone Number	:	843-323-4270
Fax Number	:	843-323-4271

Provider Business Practice Location Address
First Line	:	4000 FABER PLACE DR
Second Line	:	SUITE 327
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-8585
Country	:	US
Telephone Number	:	843-323-4270
Fax Number	:	843-323-4271

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

Provider Enumeration Date	:	12/09/2014
Last Update Date	:	12/11/2014

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