Provider Demographics
NPI:1124198445
Name:STEWART, WILLIAM P (DPM)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:STEWART
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 CAMINO RAMON
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4440
Mailing Address - Country:US
Mailing Address - Phone:925-831-1898
Mailing Address - Fax:925-831-4910
Practice Address - Street 1:2301 CAMINO RAMON
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4440
Practice Address - Country:US
Practice Address - Phone:925-831-1898
Practice Address - Fax:925-831-4910
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2498213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11361Medicare UPIN
CAZZZ01606ZMedicare ID - Type UnspecifiedMEDICARE