Provider Demographics
NPI:1972065357
Name:STEWART, MICHAEL ANTHONY II (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:STEWART
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 W MAGNOLIA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7657
Mailing Address - Country:US
Mailing Address - Phone:817-702-2977
Mailing Address - Fax:817-702-2140
Practice Address - Street 1:1500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4917
Practice Address - Country:US
Practice Address - Phone:817-702-1100
Practice Address - Fax:817-702-1101
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2024-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXT8363207P00000X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine