Provider Demographics
NPI:1164493821
Name:HOU, STEWART T (MD)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:T
Last Name:HOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 GENERAL ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2961
Mailing Address - Country:US
Mailing Address - Phone:978-946-8103
Mailing Address - Fax:978-946-8067
Practice Address - Street 1:1 GENERAL ST
Practice Address - Street 2:LAWRENCE GENERAL HOSPITAL
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2961
Practice Address - Country:US
Practice Address - Phone:978-946-8103
Practice Address - Fax:978-946-8067
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2099802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
11666526OtherCAQH
NH1164493821OtherNH ANTHEM BC/BS
MA41851OtherHEALTHY START
MA1164493821OtherMA BC/BS
NH3096864Medicaid
MA110002939AMedicaid
MA1163479OtherAETNA
MA65479OtherFALLON
MA3374068OtherCIGNA
MAAA54772OtherHPHC
MAH41981Medicare UPIN
MA110002939AMedicaid