Provider Demographics
NPI:1164607602
Name:STEWART, RODEN C (DC)
Entity Type:Individual
Prefix:DR
First Name:RODEN
Middle Name:C
Last Name:STEWART
Suffix:
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 1:6295 TEAL LN
Mailing Address - Street 2:
Mailing Address - City:CHINCOTEAGUE ISLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23336-2207
Mailing Address - Country:US
Mailing Address - Phone:757-336-7170
Mailing Address - Fax:321-800-3383
Practice Address - Street 1:6295 TEAL LN
Practice Address - Street 2:
Practice Address - City:CHINCOTEAGUE ISLAND
Practice Address - State:VA
Practice Address - Zip Code:23336-2207
Practice Address - Country:US
Practice Address - Phone:757-336-7170
Practice Address - Fax:321-800-3383
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22492OtherBCBS
FL22492OtherBCBS