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General NPI Number Information
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NPI Number | 1770165649
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Entity Type | Individual
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Provider Name | SETH ALVIN STEWART FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 6908 HOSPITALITY CIR
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City | KNOXVILLE
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State | TN
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Zip | 37909-1105
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Country | US
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Telephone | 423-223-2519
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1171
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City | WARTBURG
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State | TN
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Zip | 37887-1171
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Country | US
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Telephone | 423-223-2519
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 29308
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License Number State | TN
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