Provider Demographics
NPI:1932185105
Name:TEW, WILLIAM MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:TEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4473 WEBB RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-1620
Mailing Address - Country:US
Mailing Address - Phone:423-488-8770
Mailing Address - Fax:423-805-2764
Practice Address - Street 1:4473 WEBB RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416-1620
Practice Address - Country:US
Practice Address - Phone:423-488-8770
Practice Address - Fax:423-805-2764
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN25734207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNBT4556063OtherDEA
TNG17625Medicare UPIN
TN30938172Medicare PIN