Provider Demographics
NPI:1881045193
Name:STEWART, SARAH (DPM)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:DPM
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 164
Mailing Address - Street 2:
Mailing Address - City:GRANDVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49468-0164
Mailing Address - Country:US
Mailing Address - Phone:616-534-3920
Mailing Address - Fax:616-534-0801
Practice Address - Street 1:3550 FAIRLANES AVE SW
Practice Address - Street 2:
Practice Address - City:GRANDVILLE
Practice Address - State:MI
Practice Address - Zip Code:49418
Practice Address - Country:US
Practice Address - Phone:616-534-3920
Practice Address - Fax:616-534-0801
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002641213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery