Individual
DR. WALTER STEWART
Active
Individual
DR. WALTER STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7648
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100747
PEACHSTATE PROVIDER #
GA
01
—
9179576
WELLCARE PROVIDER #
GA
Enumeration date
11/13/2006
Last updated
07/09/2007
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