Provider Demographics
NPI:1770165649
Name:STEWART, SETH ALVIN (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:ALVIN
Last Name:STEWART
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1171
Mailing Address - Street 2:
Mailing Address - City:WARTBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37887-1171
Mailing Address - Country:US
Mailing Address - Phone:423-223-2519
Mailing Address - Fax:
Practice Address - Street 1:6908 HOSPITALITY CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1105
Practice Address - Country:US
Practice Address - Phone:423-223-2519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine