Provider Demographics
NPI:1265740393
Name:STEWART, ADAM T (RAC)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:T
Last Name:STEWART
Suffix:
Gender:M
Credentials:RAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:475 AMANDA NORTHERN RD SW
Mailing Address - Street 2:
Mailing Address - City:AMANDA
Mailing Address - State:OH
Mailing Address - Zip Code:43102-9747
Mailing Address - Country:US
Mailing Address - Phone:614-348-3127
Mailing Address - Fax:740-969-2423
Practice Address - Street 1:4765 CARROLL CEMETERY RD
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:OH
Practice Address - Zip Code:43112-9428
Practice Address - Country:US
Practice Address - Phone:614-348-3127
Practice Address - Fax:740-969-2423
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH000184171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist