Provider Demographics
NPI:1245457027
Name:MANN, STEWART C (MD)
Entity type:Individual
Prefix:
First Name:STEWART
Middle Name:C
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10752 N 89TH PL STE C128
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6744
Mailing Address - Country:US
Mailing Address - Phone:480-860-2040
Mailing Address - Fax:480-451-3535
Practice Address - Street 1:10752 N 89TH PL
Practice Address - Street 2:C-128
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6730
Practice Address - Country:US
Practice Address - Phone:480-860-2040
Practice Address - Fax:480-451-3535
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13248207R00000X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD37234Medicare UPIN