Provider Demographics
NPI:1063006187
Name:STEWARD, WALTER BENJAMIN III (DC)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:BENJAMIN
Last Name:STEWARD
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3854 CANDIES CREEK LN NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-1863
Mailing Address - Country:US
Mailing Address - Phone:423-225-2373
Mailing Address - Fax:
Practice Address - Street 1:3854 CANDIES CREEK LN NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-1863
Practice Address - Country:US
Practice Address - Phone:423-225-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3383OtherCHIROPRACTIC STATE LICENSURE NUMBER