Provider Demographics
NPI:1760448195
Name:STEWART, DANIEL HUNTER (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HUNTER
Last Name:STEWART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:HUNTER
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:210 BROOKS ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1848
Mailing Address - Country:US
Mailing Address - Phone:305-388-1930
Mailing Address - Fax:
Practice Address - Street 1:210 BROOKS ST STE 200
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1848
Practice Address - Country:US
Practice Address - Phone:305-388-1930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY37095208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64046295Medicaid
0679443Medicare ID - Type Unspecified
KY64046295Medicaid