Provider Demographics
NPI:1801882493
Name:STEWART, ROBERT DENNIS (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DENNIS
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 1:9500 EUCLID AVE
Mailing Address - Street 2:M41
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-9125
Mailing Address - Fax:216-445-3692
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:M41
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-9125
Practice Address - Fax:216-445-3692
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00314208G00000X
OH35-094328208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI14161Medicare UPIN