Healthcare Provider Details

I. General information

NPI: 1821012980
Provider Name (Legal Business Name): BRIAN SCOTT JEWETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/21/2022
Certification Date: 09/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2226 NELSON HWY STE 101
CHAPEL HILL NC
27517-9638
US

IV. Provider business mailing address

5221 PARAMOUNT PKWY STE 420
MORRISVILLE NC
27560-5491
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-6484
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number9800289
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberME83568
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: