Provider Demographics
NPI:1235255878
Name:SCHIFFMAN, STEPHEN WALTER (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WALTER
Last Name:SCHIFFMAN
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 1:1061 HARMON AVE
Mailing Address - Street 2:STE CD62
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-5641
Mailing Address - Country:US
Mailing Address - Phone:912-435-5616
Mailing Address - Fax:912-435-6305
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:STE CD62
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5641
Practice Address - Country:US
Practice Address - Phone:912-435-5616
Practice Address - Fax:912-435-6305
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA34028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA33201OtherGROUP HEALTH COOPERATIVE
WA152161OtherLABOR AND INDUSTRIES
WA152161OtherLABOR AND INDUSTRIES