Provider Demographics
NPI:1043674161
Name:HEAD, LIA STEWART (MD)
Entity Type:Individual
Prefix:
First Name:LIA
Middle Name:STEWART
Last Name:HEAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LIA
Other - Middle Name:FUSCO
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 S SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1311
Mailing Address - Country:US
Mailing Address - Phone:509-228-1000
Mailing Address - Fax:
Practice Address - Street 1:601 S SHERMAN ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1311
Practice Address - Country:US
Practice Address - Phone:509-228-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61242806207RH0003X
IL036.148545207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine