Waller, Stephen C

Waller, Stephen C is an individual health care provider with primary practice located at 6925 Shallowford Rd Suite 206, Chattanooga TN 37421-1787. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Waller, Stephen C can be contacted via phone (423) 894-0432.

Contact Information

Primary practice address
6925 Shallowford Rd Suite 206 Chattanooga TN 37421-1787
Phone: (423) 894-0432
Fax: (423) 894-0475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA0000000545 Tennessee

Profile Details

NPI number 1285678680
LBN Legal business name Waller, Stephen C
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Oct 6th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285678680 NPPES
Tennessee Other 1285678680 NPI

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