Provider Demographics
NPI:1275979734
Name:STEWARD, SHAE W (MD)
Entity Type:Individual
Prefix:
First Name:SHAE
Middle Name:W
Last Name:STEWARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAE
Other - Middle Name:A
Other - Last Name:WIDICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:250 STATE FARM PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7181
Mailing Address - Country:US
Mailing Address - Phone:205-943-4600
Mailing Address - Fax:205-943-4660
Practice Address - Street 1:250 STATE FARM PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-7181
Practice Address - Country:US
Practice Address - Phone:205-943-4600
Practice Address - Fax:205-943-4660
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA078308207W00000X
ALMD.41860207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology