Basic Information
| Provider Information | |||||||||
| NPI: | 1285156448 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEWARD | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | DWAYNE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | ARNP/FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4268 CARVER ST | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334612719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613091984 | ||||||||
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| Practice Location | |||||||||
| Address1: | 436 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | KOTZEBUE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074423321 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2017 | ||||||||
| LastUpdateDate: | 07/10/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP2656622 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.