Healthcare Provider Details

I. General information

NPI: 1073534897
Provider Name (Legal Business Name): JASON S DEW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 HUFFMAN MILL RD STE 2100
BURLINGTON NC
27215-8700
US

IV. Provider business mailing address

1238 HUFFMAN MILL RD
BURLINGTON NC
27215-8700
US

V. Phone/Fax

Practice location:
  • Phone: 336-584-4200
  • Fax: 336-584-3613
Mailing address:
  • Phone: 336-585-1869
  • Fax: 336-586-0154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2006-01019
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number2006-01019
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: