Healthcare Provider Details

I. General information

NPI: 1528090602
Provider Name (Legal Business Name): CHRISTI ANN STEWART M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CRYSTAL SPRING AVE SW STE 302
ROANOKE VA
24014-2465
US

IV. Provider business mailing address

2001 CRYSTAL SPRING AVE SW STE 302
ROANOKE VA
24014-2465
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-7653
  • Fax: 540-981-7469
Mailing address:
  • Phone: 540-981-7653
  • Fax: 540-981-7469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD427451
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101262676
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number0101262676
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: