Individual
BETHANY R STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4815 LIBERTY AVE STE 215, PITTSBURGH, PA 15224-2156
(412) 235-5900
(412) 235-5901
Mailing address
4815 LIBERTY AVE STE 215, PITTSBURGH, PA 15224-2156
(412) 235-5900
(412) 235-5901
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA052082
PA
363AS0400X
Surgical Physician Assistant
MA052082
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103205185
—
PA
01
—
13642683
CAQH
—
Enumeration date
07/27/2006
Last updated
10/08/2020
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