Provider Demographics
NPI:1699749010
Name:FEW, WALTER L III (MD)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:L
Last Name:FEW
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:975 EAST THIRD STREET
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:423-778-3110
Mailing Address - Fax:423-778-3146
Practice Address - Street 1:1614 GUNBARREL ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:423-778-8604
Practice Address - Fax:423-826-8609
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2015-05-11
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Provider Licenses
StateLicense IDTaxonomies
TN40120207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3331882Medicaid
H26847Medicare UPIN
TN3331882Medicare ID - Type Unspecified