Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | SC003192L | PA |
N | 222Z00000X | Podiatrist | SC003192L | PA |
Y | 213EP1101X | Primary Podiatric Medicine | SC003192L | PA |
NPI | 1225030067 |
---|---|
Provider Name | Mr. Timothy Patrick Stewart |
First Address | Pgh, PA 15201-3065 |
Second Address | Pgh, PA 15235-3633 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 01/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011356880004 | (05) | PA |
104075 | UPMC (01) | |
1378739 | FUNDS (01) | |
13886 | HEALTH AM (01) | |
1520253 | BLUE (01) | |
480006376 | UNITED HC (01) | |
77659 | MED PLUS (01) | |
T29236 | (02) |