Provider Demographics
NPI:1497741441
Name:STEWART, ROBYN D (DO)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:D
Last Name:STEWART
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BIRCH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2752
Mailing Address - Country:US
Mailing Address - Phone:603-421-2526
Mailing Address - Fax:603-421-2568
Practice Address - Street 1:44 BIRCH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2752
Practice Address - Country:US
Practice Address - Phone:603-421-2526
Practice Address - Fax:603-421-2568
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH17240207Q00000X
MA223893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3102808Medicaid
MAA3853401Medicare PIN
NH3102808Medicaid
NHT400252824Medicare PIN
NHRAILROAD P01550094Medicare PIN
I15690Medicare UPIN