Provider Demographics
NPI:1922094804
Name:STEWART, THOMAS CHRISTOPHER (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:CHRISTOPHER
Last Name:STEWART
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W NEWTON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-6416
Mailing Address - Country:US
Mailing Address - Phone:412-608-0132
Mailing Address - Fax:
Practice Address - Street 1:132 GRANITE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5060
Practice Address - Country:US
Practice Address - Phone:617-479-2330
Practice Address - Fax:617-479-2601
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0006296183500000X
MAPH233952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist