Provider Demographics
NPI:1013081256
Name:STEWART, ERIN P (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:P
Last Name:STEWART
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 2510
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-2510
Mailing Address - Country:US
Mailing Address - Phone:706-922-8274
Mailing Address - Fax:706-922-6695
Practice Address - Street 1:131 RINEHART WAY
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-1703
Practice Address - Country:US
Practice Address - Phone:803-335-2200
Practice Address - Fax:803-649-7966
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004937363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA004937OtherLICENSE
GA004937OtherLICENSE