Provider Demographics
NPI:1477567022
Name:KARR, STEWART B (MD)
Entity Type:Individual
Prefix:
First Name:STEWART
Middle Name:B
Last Name:KARR
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 1:4718 CARR DRIVE
Mailing Address - Street 2:PER SE TECHNOLOGIES ELLIE CONLEY
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408
Mailing Address - Country:US
Mailing Address - Phone:540-891-5764
Mailing Address - Fax:540-891-5769
Practice Address - Street 1:2121 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 3
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902
Practice Address - Country:US
Practice Address - Phone:501-681-3003
Practice Address - Fax:301-681-5868
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00358682085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC80430026OtherBLUE SHIELD
MD60234801OtherBLUE SHIELD
MD152651100Medicaid
DC80430026OtherBLUE SHIELD
DC008912C85Medicare PIN
F16431Medicare UPIN
MD152651100Medicaid