Provider Demographics
NPI:1104932169
Name:STEWART, RICHARD ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:STEWART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-932-5162
Mailing Address - Fax:540-932-5875
Practice Address - Street 1:201 LEW DEWITT BLVD STE B
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980
Practice Address - Country:US
Practice Address - Phone:540-245-7950
Practice Address - Fax:540-245-7951
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044428207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
381803OtherTRIGON
VA010341817Medicaid
VAP00480314OtherMEDICARE PIN
110211597OtherMEDICARE RAILROAD
VA4498516OtherCIGNA
VA8162778OtherMAMSI
158314OtherSOUTHERN HEALTH
VAP00458004OtherPALMETTO GBA
VA443049OtherSOUTHERN HEALTH
VA337992OtherANTHEM SERVICES/HEALTHKEEPERS
VA221019OtherANTHEM
VA5848474Medicaid
VA45317OtherCOMMUNITY HEALTH
VA221019OtherANTHEM
VA45317OtherCOMMUNITY HEALTH
VA443049OtherSOUTHERN HEALTH
VA337992OtherANTHEM SERVICES/HEALTHKEEPERS