Provider Demographics
NPI:1245605120
Name:STEWART, JAMES H (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
Last Name:STEWART
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 AUTUMN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KESWICK
Mailing Address - State:VA
Mailing Address - Zip Code:22947-3234
Mailing Address - Country:US
Mailing Address - Phone:434-531-0885
Mailing Address - Fax:
Practice Address - Street 1:302 HICKMAN RD STE 202
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3572
Practice Address - Country:US
Practice Address - Phone:434-245-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101001953174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist