Provider Demographics
NPI:1437196151
Name:STEWART, DEBORAH CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:CLAIRE
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2668 RIO BRAVO CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2212
Mailing Address - Country:US
Mailing Address - Phone:916-734-8397
Mailing Address - Fax:916-734-5644
Practice Address - Street 1:3300 STOCKTON BLVD
Practice Address - Street 2:CAARE DIAGNOSTIC & TREATMENT CENTER
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820
Practice Address - Country:US
Practice Address - Phone:916-734-8397
Practice Address - Fax:916-734-5644
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38567174400000X, 208D00000X, 207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No174400000XOther Service ProvidersSpecialist
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG38567OtherMEDICAL LICENSE NUMBER
CAZZZP5701ZMedicare ID - Type Unspecified
CAA47522Medicare UPIN