Stewart, Edward Granville
Stewart, Edward Granville is an individual health care provider with primary practice located at 515 W 14Th St Suite D, Traverse City MI 49684-4059. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Stewart, Edward Granville can be contacted via phone (231) 947-2020.Contact Information
Primary practice address
515 W 14Th St Suite D
Traverse City MI 49684-4059
Phone: (231) 947-2020
Fax: (231) 947-2002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004160 | Michigan |
Profile Details
| NPI number | 1659358901 |
|---|---|
| LBN Legal business name | Stewart, Edward Granville |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2005 |
| Last updated | May 20th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659358901 | NPPES |
| Michigan | MEDICAID | 944697888 |
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