Dewitt, Dana Andre

Dewitt, Dana Andre is an individual health care provider with primary practice located at 300 W Washington Ave Ste 150, Jackson MI 49201-2180. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dewitt, Dana Andre can be contacted via phone (517) 783-4664.

Contact Information

Primary practice address
300 W Washington Ave Ste 150 Jackson MI 49201-2180
Phone: (517) 783-4664
Fax: (517) 783-4698
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5101012782 Michigan

Profile Details

NPI number 1124016639
LBN Legal business name Dewitt, Dana Andre
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2005
Last updated Oct 4th, 2011 - about 13 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 1124016639 NPPES
Other 0120233 PHYSCIAN HEALTH PLAN MA
MEDICAID 4080108 PHYSCIAN HEALTH PLAN MA
Other 700C86358 PHYSCIAN HEALTH PLAN MA

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