Provider Demographics
NPI:1437235439
Name:STEWART, JAMES A (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:STEWART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4041 TAYLOR RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5525
Mailing Address - Country:US
Mailing Address - Phone:757-484-5828
Mailing Address - Fax:757-484-4371
Practice Address - Street 1:4041 TAYLOR RD
Practice Address - Street 2:SUITE G
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5525
Practice Address - Country:US
Practice Address - Phone:757-484-5828
Practice Address - Fax:757-484-4371
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101026604207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA016650OtherANTHEM BCBS OF VA
VA22008OtherSENTARA OPTIMA OF VIRGINA
VA200144OtherSENTARA OPTIMA VENDOR #
VA6075304Medicaid
VA0000000003812OtherANTHEM BCBS GROUP NUMBER
110019575OtherRAILROAD MEDICARE
VA101268OtherCIGNA HEALTHCARE
VA22008OtherSENTARA OPTIMA OF VIRGINA
VA22008OtherSENTARA OPTIMA OF VIRGINA
110019575OtherRAILROAD MEDICARE
B09913Medicare UPIN
C12158Medicare ID - Type UnspecifiedGROUP RAILROAD MEDICARE #