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NPI Code Detail

MEDICARE: DEWAR MEDICAL GROUP INC

MEDICARE: DEWAR MEDICAL GROUP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianA33700CA

General Provider Information

NPI Number : 1023323870
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEWAR MEDICAL GROUP INC
Provider Business Mailing Address
First Line : 399 E HIGHLAND AVE STE 124
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92404-3854
Country : US
Telephone Number : 909-886-6576
Fax Number : 909-882-1299
Provider Business Practice Location Address
First Line : 399 E HIGHLAND AVE STE 124
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92404-3854
Country : US
Telephone Number : 909-886-6576
Fax Number : 909-882-1299
Authorized Official
Title or Position : PRESIDENT
Name : DR. SENECA T DEWAR
Credential : MD
Telephone Number : 909-886-6576
Provider Enumeration Date : 08/17/2010
Last Update Date : 08/17/2010

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