Provider Demographics
NPI:1952618738
Name:STEWART, KIM MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:MARIE
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:118 MOOSEHEAD TRL
Mailing Address - Street 2:STE 5
Mailing Address - City:NEWPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04953-4055
Mailing Address - Country:US
Mailing Address - Phone:207-368-5189
Mailing Address - Fax:207-368-4213
Practice Address - Street 1:118 MOOSEHEAD TRL
Practice Address - Street 2:STE 5
Practice Address - City:NEWPORT
Practice Address - State:ME
Practice Address - Zip Code:04953-4055
Practice Address - Country:US
Practice Address - Phone:207-368-5189
Practice Address - Fax:207-368-4213
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH15007208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics