Dewall, Jeremy

Dewall, Jeremy is an individual health care provider with primary practice located at 16420 W Us Highway 24 , Woodland Park CO 80863. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Dewall, Jeremy can be contacted via phone (719) 687-9999.

Contact Information

Primary practice address
16420 W Us Highway 24 Woodland Park CO 80863
Phone: (719) 687-9999
Fax: (303) 306-7753
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2365-850 Wisconsin
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 48580 Colorado

Profile Details

NPI number 1477672863
LBN Legal business name Dewall, Jeremy
Credentials MD, NREMT-P
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Nov 6th, 2019 - about 6 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 1477672863 NPPES
Colorado MEDICAID 30489377

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