Provider Demographics
NPI:1215014659
Name:STEWART, ANTOINETTE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:MARIE
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 1:306 WESTWOOD OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5108
Mailing Address - Country:US
Mailing Address - Phone:540-699-0226
Mailing Address - Fax:540-699-0224
Practice Address - Street 1:306 WESTWOOD OFFICE PARK
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5108
Practice Address - Country:US
Practice Address - Phone:540-699-0226
Practice Address - Fax:540-699-0224
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-14772084P0800X
VA01012369412084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902445Medicaid
NC5902445Medicaid