Individual
DR. ROBERT CALVERT STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4402 CHURCHMAN AVE, SUITE 202, LOUISVILLE, KY 40215-1190
(502) 366-1090
(502) 366-1564
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 366-1090
(502) 366-1564
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
30613
KY
208600000X
Surgery Physician
Primary
30613
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01044681A
IN MEDICAL LICENSE #
IN
05
—
100375540A
—
IN
01
—
30613
KY MEDICAL LICENSE #
KY
05
—
64306137
—
KY
01
—
F80628
UNIQUE PROVIDER ID#
KY
01
—
P01026556
MEDICARE RAILROAD
KY
Enumeration date
06/23/2005
Last updated
01/23/2019
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