Provider Demographics
NPI:1659455368
Name:STEWART, DONALD T (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:T
Last Name:STEWART
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 1:3854 E LK SAMMAMISH PKWY NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-4534
Mailing Address - Country:US
Mailing Address - Phone:425-996-7047
Mailing Address - Fax:425-996-7087
Practice Address - Street 1:3854 E LK SAMMAMISH PKWY NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-4534
Practice Address - Country:US
Practice Address - Phone:425-996-7047
Practice Address - Fax:425-996-7087
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019303207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine