Healthcare Provider Details

I. General information

NPI: 1689186694
Provider Name (Legal Business Name): PATRICK EUGENE DEWEES NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 10/04/2022
Certification Date: 08/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 JACKSON PIKE
GALLIPOLIS OH
45631-1560
US

IV. Provider business mailing address

1612 N MEMORIAL DR
LANCASTER OH
43130-1631
US

V. Phone/Fax

Practice location:
  • Phone: 740-446-5000
  • Fax:
Mailing address:
  • Phone: 740-994-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number113622
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.021991
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: