Provider Demographics
NPI:1215014659
Name:STEWART, ANTOINETTE MARIE (MD)
Entity type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:MARIE
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 1:11921 ROCKVILLE PIKE STE 402
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2757
Mailing Address - Country:US
Mailing Address - Phone:425-658-2254
Mailing Address - Fax:301-888-8261
Practice Address - Street 1:11921 ROCKVILLE PIKE STE 402
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2757
Practice Address - Country:US
Practice Address - Phone:425-658-2254
Practice Address - Fax:301-888-8261
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012369412084P0804X
NC2005-14772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902445Medicaid
NC5902445Medicaid