Individual
DR. STEWART ESTABROOK SULLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
55 PORTLAND RD, BRIDGTON, ME 04009-1230
(207) 647-3504
(207) 647-5862
Mailing address
55 PORTLAND RD, BRIDGTON, ME 04009-1230
(207) 647-3504
(207) 647-5862
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CR755
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039429
BCBS
ME
01
—
234252
AETNA
—
01
—
M20915
CIGNA
—
Enumeration date
05/07/2007
Last updated
07/08/2007
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