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NPI Code Detail

MEDICARE: CHARLES VINCENT STEWART M.D.

MEDICARE: CHARLES VINCENT STEWART M.D.
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
1207L00000XAnesthesiology Physician16144OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831195155
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES VINCENT STEWART M.D.
Provider Business Mailing Address
First Line : PO BOX 22063
Second Line : DEPT 7175
City : TULSA
State : OK
Zip : 74121-2063
Country : US
Telephone Number : 918-664-9892
Fax Number : 918-664-2521
Provider Business Practice Location Address
First Line : 6901 S OLYMPIA AVE
Second Line :
City : TULSA
State : OK
Zip : 74132-1843
Country : US
Telephone Number : 918-664-9892
Fax Number : 918-664-2521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 04/07/2010

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Directions to “ CHARLES VINCENT STEWART M.D.” Practice Location

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