Provider Demographics
NPI:1700871928
Name:STEWART, BARBARA (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
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:PO BOX 28949
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-8949
Mailing Address - Country:US
Mailing Address - Phone:559-228-4200
Mailing Address - Fax:559-224-3920
Practice Address - Street 1:31981 LODGE RD # 102
Practice Address - Street 2:
Practice Address - City:AUBERRY
Practice Address - State:CA
Practice Address - Zip Code:93602-9753
Practice Address - Country:US
Practice Address - Phone:559-855-3601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2024-05-10
Deactivation Date:2024-04-08
Deactivation Code:
Reactivation Date:2024-05-10
Provider Licenses
StateLicense IDTaxonomies
CAG49553207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH17251Medicaid
CAH17251Medicaid
CAA51400Medicare UPIN
CA080080249Medicare PIN