Charles Douglas Stewart, PA C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

00071 Issued in WV

Practice address

111 Beechwood Est
Scott Depot, WV 25560-9723

Phone

(304) 347-6120

NPI assigned

Jul 10, 2006

Last updated

Aug 23, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• C. Douglas Stewart Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1548294440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BEECHWOOD EST",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BEECHWOOD EST",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609723",
            "telephone_number": "304-347-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "00071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C.",
            "last_name": "STEWART",
            "middle_name": "DOUGLAS",
            "credential": "PA C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Medical Physician Assistant in Scott Depot, WV
• Providers in Scott Depot, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.