Provider Demographics
NPI:1275662330
Name:STEWARD, ERIC STEVEN (ATC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:STEVEN
Last Name:STEWARD
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43216 CHOKEBERRY SQ
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4464
Mailing Address - Country:US
Mailing Address - Phone:703-858-5318
Mailing Address - Fax:
Practice Address - Street 1:21300 REDSKIN PARK DR
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6100
Practice Address - Country:US
Practice Address - Phone:703-726-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260007822255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer