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General NPI Number Information
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NPI Number | 1215442546
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Entity Type | Individual
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Provider Name | SHAWNA DEWITT CPM
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Gender | Female
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 12/08/2017
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Provider Practice Location Address
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Address Line | 3620 BUCKEYSTOWN PIKE
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City | BUCKEYSTOWN
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State | MD
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Zip | 21717-1001
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Country | US
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Telephone | 240-341-4974
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Fax |
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Provider Business Mailing Address
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Address Line | 11661 HARPERS FERRY RD
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City | PURCELLVILLE
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State | VA
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Zip | 20132-1944
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 0129000129
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License Number State | VA
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