MEDICARE: DR. RAYMOND STEWART M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	034465	CT

General Provider Information

NPI Number	:	1891794848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND STEWART M.D.

Provider Business Mailing Address
First Line	:	727 HONEYSPOT RD
Second Line	:
City	:	STRATFORD
State	:	CT
Zip	:	06615-7172
Country	:	US
Telephone Number	:	203-375-7245
Fax Number	:	203-332-0376

Provider Business Practice Location Address
First Line	:	727 HONEYSPOT RD
Second Line	:
City	:	STRATFORD
State	:	CT
Zip	:	06615-7172
Country	:	US
Telephone Number	:	203-375-7245
Fax Number	:	203-332-0376

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	07/16/2010

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