Provider Demographics
NPI:1629078472
Name:STEWARD, ROBERT E JR (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:STEWARD
Suffix:JR
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 1:809 TURNPIKE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-1232
Mailing Address - Country:US
Mailing Address - Phone:814-768-2356
Mailing Address - Fax:814-768-2134
Practice Address - Street 1:1049 N FRONT ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-8258
Practice Address - Country:US
Practice Address - Phone:814-342-9186
Practice Address - Fax:814-342-6684
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014352E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006829760007Medicaid
PAP00140176OtherRAILROAD MEDICARE
PA123825OtherHIGHMARK BCBS
PAC30864Medicare UPIN
PA123825Medicare PIN