Provider Demographics
NPI:1467423491
Name:STEWART-HUBBARD, TAKASHA LATOYA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:TAKASHA
Middle Name:LATOYA RENEE
Last Name:STEWART-HUBBARD
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 1:1201 7TH ST SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3337
Mailing Address - Country:US
Mailing Address - Phone:256-973-2909
Mailing Address - Fax:256-973-2552
Practice Address - Street 1:1201 7TH ST SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3337
Practice Address - Country:US
Practice Address - Phone:256-973-2909
Practice Address - Fax:256-973-2552
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39082207R00000X
TN41071208M00000X
AL41602208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3834297Medicare PIN
103I116284Medicare PIN
H98561Medicare UPIN