Provider Demographics
NPI:1053002568
Name:SWEETING, STEPHEN JR
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:SWEETING
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 PYTHON DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7650
Mailing Address - Country:US
Mailing Address - Phone:678-358-9504
Mailing Address - Fax:
Practice Address - Street 1:733 PYTHON DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-7650
Practice Address - Country:US
Practice Address - Phone:678-358-9504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle