Provider Demographics
NPI:1093295875
Name:MCCREARY-STEWARD, RICARDO DANTE
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:DANTE
Last Name:MCCREARY-STEWARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 S ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1525
Mailing Address - Country:US
Mailing Address - Phone:202-427-5627
Mailing Address - Fax:
Practice Address - Street 1:217 S ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1525
Practice Address - Country:US
Practice Address - Phone:202-427-5627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant