Healthcare Provider Details

I. General information

NPI: 1346314382
Provider Name (Legal Business Name): JOHN BARTLEY STEWART JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN B STEWART JR. MD

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 EAST MAIN STREET 101 KELWAY PLAZA
NEWARK DE
19711
US

IV. Provider business mailing address

314 EAST MAIN STREET 101 KELWAY PLAZA
NEWARK DE
19711
US

V. Phone/Fax

Practice location:
  • Phone: 302-737-3281
  • Fax: 302-738-8750
Mailing address:
  • Phone: 302-737-3281
  • Fax: 302-738-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC10000299
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: