Provider Demographics
NPI:1801889654
Name:STEWART, RONALD J (DO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:STEWART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:293 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-2138
Mailing Address - Country:US
Mailing Address - Phone:248-540-4142
Mailing Address - Fax:248-540-4186
Practice Address - Street 1:42370 VAN DYKE AVE
Practice Address - Street 2:STE#100
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3487
Practice Address - Country:US
Practice Address - Phone:586-254-1177
Practice Address - Fax:586-254-5973
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRS005546207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1006386Medicaid
MIE26678Medicare UPIN
MI1006386Medicaid