Healthcare Provider Details

I. General information

NPI: 1255310652
Provider Name (Legal Business Name): CHARMAINE A STEWART M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E LEIGH ST
RICHMOND VA
23298-5004
US

IV. Provider business mailing address

PO BOX 780125
PHILADELPHIA PA
19178-0125
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-2467
  • Fax: 804-828-5348
Mailing address:
  • Phone: 804-922-4844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number64607
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number64607
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number0101054312
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: