Provider Demographics
NPI:1407818313
Name:STEWART, MARIAN BARRAUD (MD)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:BARRAUD
Last Name:STEWART
Suffix:
Gender:F
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:PO BOX 10
Mailing Address - Street 2:14088 ALABAMA STREET
Mailing Address - City:JAY
Mailing Address - State:FL
Mailing Address - Zip Code:32565-1036
Mailing Address - Country:US
Mailing Address - Phone:850-675-4546
Mailing Address - Fax:850-675-4548
Practice Address - Street 1:14088 ALABAMA STREET
Practice Address - Street 2:
Practice Address - City:JAY
Practice Address - State:FL
Practice Address - Zip Code:32565-1036
Practice Address - Country:US
Practice Address - Phone:850-675-4546
Practice Address - Fax:850-675-4548
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68044208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051359OtherVISTA
FL32119OtherPREFERRED PATIENT CARE
FL32119OtherBLUE CROSS AND BLUE SHIELD OF FLORIDA
5173714OtherAETNA CONTAINER
541009001OtherALACAID
AL009905570OtherALACAID
1206338OtherAARP HEALTHCARE UNITED
TX160274001OtherTEXAS MEDICAID
Q68044OtherDEPARTMENT OF PHYS SE
FL32119OtherHEALTH 1ST NETWORK
5173714OtherAETNA
FL5173714OtherAETNA GLOBAL BENEFITS
AL541900103OtherALACAID
AL59176907OtherBLUE CROSS AND BLUE SHIELD OF ALABAMA
FL660022100Medicaid
160461OtherHEALTHEASE HEALTH 1ST
AL59109002OtherBLUE CROSS AND BLUE SHIELD OF ALABAMA
32119OtherHEALTH OPTIONS
5173714OtherAETNA US HEALTHCARE
593216460OtherCHILDRENS MEDICAL SECURIT
FL5173714OtherAETNA US HEALTHCARE
015443OtherPCA FAMILY HEALTH PLAN
FL251076600Medicaid
FL4878883OtherCIGNA HEALTHCARE
FL4878883OtherCIGNA INTERNATIONAL
5173714OtherAETNA LIFE INS CO
FL660022102Medicaid
FL1206338OtherUNITED HEALTHCARE
FL251076600Medicaid