MEDICARE: DR. BRIDGET M. DEWEY M.D.

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
1	208000000X	Pediatrics Physician	43633	MN
2	207R00000X	Internal Medicine Physician	43633	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073516647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIDGET M. DEWEY M.D.

Provider Business Mailing Address
First Line	:	707 LUNDORFF DR STE 1
Second Line	:
City	:	SANDSTONE
State	:	MN
Zip	:	55072-5099
Country	:	US
Telephone Number	:	320-245-2250
Fax Number	:	320-245-2555

Provider Business Practice Location Address
First Line	:	707 LUNDORFF DR STE 1
Second Line	:
City	:	SANDSTONE
State	:	MN
Zip	:	55072-5099
Country	:	US
Telephone Number	:	320-245-2250
Fax Number	:	320-245-2555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	07/18/2024

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