Provider Demographics
NPI:1164453056
Name:STEWART, HOLLY ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ELLEN
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3241 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-4513
Mailing Address - Country:US
Mailing Address - Phone:412-448-6121
Mailing Address - Fax:
Practice Address - Street 1:412 E COMMONS
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5310
Practice Address - Country:US
Practice Address - Phone:412-323-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4251912084P0800X
CAC552272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry