Provider Demographics
NPI:1073923751
Name:STEWART, STEVIE BYRAM (PA)
Entity Type:Individual
Prefix:
First Name:STEVIE
Middle Name:BYRAM
Last Name:STEWART
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PLZ
Mailing Address - Street 2:SUITE 900
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2629
Mailing Address - Country:US
Mailing Address - Phone:205-271-8000
Mailing Address - Fax:205-271-8050
Practice Address - Street 1:1 INDEPENDENCE PLZ
Practice Address - Street 2:SUITE 900
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2629
Practice Address - Country:US
Practice Address - Phone:205-271-8000
Practice Address - Fax:205-271-8050
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.1102363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC02397Medicare PIN