Provider Demographics
NPI:1396819553
Name:STEWART, RONALD M (MD)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:M
Last Name:STEWART
Suffix:
Gender:M
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:PO BOX 1687
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502-1687
Mailing Address - Country:US
Mailing Address - Phone:970-263-2600
Mailing Address - Fax:
Practice Address - Street 1:2373 G RD
Practice Address - Street 2:SUITE 240
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1002
Practice Address - Country:US
Practice Address - Phone:970-243-7908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00150171207V00000X
COCO 28161207V00000X
ORMD150171207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01281617Medicaid
OR500612505Medicaid
COT9888Medicare PIN
E23392Medicare UPIN
MO152360058Medicare PIN
ORR149678Medicare PIN