Provider Demographics
NPI:1083774939
Name:STEWART, WILLIAM JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:STEWART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 SECOND AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15207-1624
Mailing Address - Country:US
Mailing Address - Phone:412-521-8890
Mailing Address - Fax:
Practice Address - Street 1:5003 SECOND AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15207-1624
Practice Address - Country:US
Practice Address - Phone:412-521-8890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001850L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA202022OtherUPMC
PA336526OtherHEALTH ASSURANCE
PA126407OtherHIGHMARK
PA1022424OtherGATEWAY HEALTH
PA000630826 0001Medicaid
PA1022424OtherGATEWAY HEALTH