Provider Demographics
NPI:1972673002
Name:STEWART, GEORGE H (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:H
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 1:2340 WARD ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1124
Mailing Address - Country:US
Mailing Address - Phone:510-644-4440
Mailing Address - Fax:
Practice Address - Street 1:2340 WARD ST
Practice Address - Street 2:SUITE 107
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1124
Practice Address - Country:US
Practice Address - Phone:510-644-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG148612084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry