Provider Demographics
NPI:1154491371
Name:WILLIAM STEWART, D.P.M.
Entity Type:Organization
Organization Name:WILLIAM STEWART, D.P.M.
Other - Org Name:SAN RAMON VALLEY PODIATRY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:925-831-1898
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2498213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ01606ZMedicare PIN
CAT11361Medicare UPIN
CA5396990001Medicare NSC