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NPI Code Detail

MEDICARE: MICHAEL HEWITT

MEDICARE: MICHAEL HEWITT
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1164158861
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL HEWITT
Provider Business Mailing Address
First Line : 8072 S HIGHLAND DR
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-5037
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8072 S HIGHLAND DR
Second Line :
City : COTTONWOOD HEIGHTS
State : UT
Zip : 84121-5037
Country : US
Telephone Number : 385-351-5483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2022
Last Update Date : 07/26/2022

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