Provider Demographics
NPI:1346314382
Name:STEWART, JOHN BARTLEY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BARTLEY
Last Name:STEWART
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:B
Other - Last Name:STEWART
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:314 EAST MAIN STREET
Mailing Address - Street 2:101 KELWAY PLAZA
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711
Mailing Address - Country:US
Mailing Address - Phone:302-737-3281
Mailing Address - Fax:302-738-8750
Practice Address - Street 1:314 EAST MAIN STREET
Practice Address - Street 2:101 KELWAY PLAZA
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711
Practice Address - Country:US
Practice Address - Phone:302-737-3281
Practice Address - Fax:302-738-8750
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10000299208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000202001Medicaid
DE0000202001Medicaid