Dewitt, Corey

Dewitt, Corey is an sole proprietor health care provider with primary practice located at 19465 Deerfield Avenue, Suite 401 , Leesburg VA 20176-1707. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Dewitt, Corey can be contacted via phone (703) 723-5700.

Contact Information

Primary practice address
19465 Deerfield Avenue, Suite 401 Leesburg VA 20176-1707
Phone: (703) 723-5700
Fax: (703) 723-5778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD23389 Maine
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X D91604 Maryland
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 0101275415 Virginia

Profile Details

NPI number 1417342890
LBN Legal business name Dewitt, Corey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 1st, 2015
Last updated Nov 29th, 2023 - about 2 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 1417342890 NPPES
Virginia MEDICAID 30017465030001
Virginia MEDICAID 1417342890

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