Dewberry, Michael John
Dewberry, Michael John is an individual health care provider with primary practice located at 444 Center St , Manchester CT 06040-3926. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Dewberry, Michael John can be contacted via phone (860) 646-3888.Contact Information
Primary practice address
444 Center St
Manchester CT 06040-3926
Phone: (860) 646-3888
Fax: (860) 645-4132
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 049015 | Connecticut |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X |
Profile Details
| NPI number | 1053574442 |
|---|---|
| LBN Legal business name | Dewberry, Michael John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2008 |
| Last updated | Feb 6th, 2017 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053574442 | NPPES |
| Connecticut | MEDICAID | 001490150 |
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