Basic Information
| Provider Information | |||||||||
| NPI: | 1689882136 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEWART | ||||||||
| FirstName: | CHERE MICHELLE | ||||||||
| MiddleName: | LEBERTE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 55310 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352555310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057318701 | ||||||||
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| Practice Location | |||||||||
| Address1: | 619 19TH ST S | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352491900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059345038 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 01/19/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 27149 | AL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | P00799675 | 01 | AL | RAILROAD MEDICARE | OTHER | 051548820 | 01 | AL | BCBS | OTHER | 101994 | 05 | AL | MEDICAID | 102017 | 05 | AL | MEDICAID | 051548821 | 01 | AL | BCBS | OTHER | 051548817 | 01 | AL | BCBS | OTHER | 102018 | 05 | AL | MEDICAID | 051109568 | 01 | AL | BCBS | OTHER | 101999 | 05 | AL | MEDICAID | 123063 | 05 | AL | MEDICAID | 051548818 | 01 | AL | BCBS | OTHER | Z09073 | 01 | AL | VIVA | OTHER |