Provider Demographics
NPI:1245433937
Name:STEWART, SHERMAN LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:SHERMAN
Middle Name:LYNN
Last Name:STEWART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:SHERMAN
Other - Middle Name:LYNN
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3670 GRANT DR STE 105C
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6300
Mailing Address - Country:US
Mailing Address - Phone:775-786-2863
Mailing Address - Fax:
Practice Address - Street 1:3670 GRANT DR STE 105C
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6300
Practice Address - Country:US
Practice Address - Phone:775-786-2863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVDC482Medicare ID - Type UnspecifiedCHIROPRACTOR