Provider Demographics
NPI:1154454353
Name:STEWART, ADRIENNE ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:ELIZABETH
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3300 EAST 1ST AVENUE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5817
Mailing Address - Country:US
Mailing Address - Phone:303-333-6060
Mailing Address - Fax:303-333-9239
Practice Address - Street 1:3300 E 1ST AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5810
Practice Address - Country:US
Practice Address - Phone:303-333-6060
Practice Address - Fax:303-333-9239
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO30356207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COST86691OtherBLUE SHIELD
ST86691OtherBLUE SHIELD
CO86691Medicare PIN
COE33976Medicare UPIN