Stewart, Michael Gordon

Stewart, Michael Gordon is an individual health care provider with primary practice located at 1101 Health Professions Bldg , Mt Pleasant MI 48859-0001. He recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter. Speech, Language and Hearing Service Providers / Audiologist is his primary health care specialty. Stewart, Michael Gordon can be contacted via phone (989) 774-3904.

Contact Information

Primary practice address
1101 Health Professions Bldg Mt Pleasant MI 48859-0001
Phone: (989) 774-3904
Fax: (989) 774-1891
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 1601000250 Michigan
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 1601000250 Michigan

Profile Details

NPI number 1114008711
LBN Legal business name Stewart, Michael Gordon
Credentials PHD, CCC-A
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated May 1st, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114008711 NPPES
Michigan Other 1601000250 STATE LICENSE
Michigan Other 640C32605 STATE LICENSE
Michigan Other 00719898 STATE LICENSE
Michigan MEDICAID 40-4683793 STATE LICENSE
Michigan MEDICAID 90-2628470 STATE LICENSE

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