Provider Demographics
NPI:1245788868
Name:STEWART, MARSHALL DAYNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARSHALL
Middle Name:DAYNE
Last Name:STEWART
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15214-3641
Mailing Address - Country:US
Mailing Address - Phone:724-944-0367
Mailing Address - Fax:
Practice Address - Street 1:100 FORBES AVE STE 100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1804
Practice Address - Country:US
Practice Address - Phone:412-338-8614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP446851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist