Provider Demographics
NPI:1275511131
Name:STEWART, PAUL D (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:STEWART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S 5TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3906
Mailing Address - Country:US
Mailing Address - Phone:785-827-2238
Mailing Address - Fax:785-827-1684
Practice Address - Street 1:200 S 5TH ST STE A
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3906
Practice Address - Country:US
Practice Address - Phone:785-827-2238
Practice Address - Fax:785-827-1684
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-02
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-30789207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200260040AMedicaid
KS103744Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
KS200260040AMedicaid