Provider Demographics
NPI:1053078972
Name:STEWART, EVERETT (MBA, IP, CMSBB)
Entity Type:Individual
Prefix:MR
First Name:EVERETT
Middle Name:
Last Name:STEWART
Suffix:
Gender:M
Credentials:MBA, IP, CMSBB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 S WALNUT ST APT 206
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-2367
Mailing Address - Country:US
Mailing Address - Phone:330-808-7387
Mailing Address - Fax:
Practice Address - Street 1:21 S WALNUT ST APT 206
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-2367
Practice Address - Country:US
Practice Address - Phone:330-808-7387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-27
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide