Provider Demographics
NPI:1144234238
Name:STEWART, JOHN PURDY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PURDY
Last Name:STEWART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 OAKLAND RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4820
Mailing Address - Country:US
Mailing Address - Phone:828-253-5381
Mailing Address - Fax:828-253-9087
Practice Address - Street 1:41 OAKLAND RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4820
Practice Address - Country:US
Practice Address - Phone:828-253-5381
Practice Address - Fax:828-253-9087
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31078174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8979893Medicaid
NC210706Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER