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NPI Code Detail

MEDICARE: CHARLES RUSSELL STEWART

MEDICARE: CHARLES RUSSELL 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
1171M00000XCase Manager/Care Coordinator
23747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1902424203
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES RUSSELL STEWART
Provider Business Mailing Address
First Line : 2727 S 3RD ST
Second Line :
City : IRONTON
State : OH
Zip : 45638-2760
Country : US
Telephone Number : 740-534-2100
Fax Number :
Provider Business Practice Location Address
First Line : 2727 S 3RD ST
Second Line :
City : IRONTON
State : OH
Zip : 45638-2760
Country : US
Telephone Number : 740-534-2100
Fax Number : 877-384-2939
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2020
Last Update Date : 07/21/2025

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Directions to “ CHARLES RUSSELL STEWART ” Practice Location

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