=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184620593
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN ALBERT DEW JR. M. D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2005
-----------------------------------------------------
Last Update Date | 03/18/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 321 MULBERRY ST SW CALDWELL ACUTE CARE SPECIALISTS
-----------------------------------------------------
City | LENOIR
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28645-5720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-757-5504
-----------------------------------------------------
Fax | 828-757-5501
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 321 MULBERRY ST SW CALDWELL ACUTE CARE SPECIALISTS
-----------------------------------------------------
City | LENOIR
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28645-5720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-757-5504
-----------------------------------------------------
Fax | 828-757-5501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 33984
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------