Provider Demographics
NPI:1437130382
Name:STEWART, TIMOTHY ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ANDREW
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 1:1963 MEMORIAL PKWY SW
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5036
Mailing Address - Country:US
Mailing Address - Phone:256-265-2464
Mailing Address - Fax:256-265-2466
Practice Address - Street 1:1963 MEMORIAL PKWY SW
Practice Address - Street 2:SUITE 5
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5036
Practice Address - Country:US
Practice Address - Phone:256-265-2464
Practice Address - Fax:256-265-2466
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10983208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC76879Medicare UPIN