Provider Demographics
NPI:1891794848
Name:STEWART, RAYMOND (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
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 1:727 HONEYSPOT RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-7172
Mailing Address - Country:US
Mailing Address - Phone:203-375-7245
Mailing Address - Fax:203-332-0376
Practice Address - Street 1:727 HONEYSPOT RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-7172
Practice Address - Country:US
Practice Address - Phone:203-375-7245
Practice Address - Fax:203-332-0376
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG03552Medicare UPIN
CT370000998Medicare PIN