Provider Demographics
NPI:1740342310
Name:STEWART, DARIN DEWAYNE (CRNA)
Entity type:Individual
Prefix:
First Name:DARIN
Middle Name:DEWAYNE
Last Name:STEWART
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:678 GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:DANIELS
Mailing Address - State:WV
Mailing Address - Zip Code:25832-9597
Mailing Address - Country:US
Mailing Address - Phone:304-763-3594
Mailing Address - Fax:304-763-3234
Practice Address - Street 1:500 CHERRY ST
Practice Address - Street 2:BLUEFIELD REGIONAL MEDICAL CENTER
Practice Address - City:BLUEFIELD
Practice Address - State:WV
Practice Address - Zip Code:24701-3306
Practice Address - Country:US
Practice Address - Phone:304-327-1681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV52798367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered