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General NPI Number Information
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NPI Number | 1760693261
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Entity Type | Organization
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Legal Business Name | JEWETT PODIATRY CENTER
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 7 FEDERAL ST SUITE 33
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City | DANVERS
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State | MA
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Zip | 01923-3620
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Country | US
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Telephone | 978-774-2628
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Fax | 978-774-4050
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Provider Business Mailing Address
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Address Line | 7 FEDERAL ST
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City | DANVERS
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State | MA
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Zip | 01923-3620
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Country | US
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Telephone | 978-774-2628
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Fax | 978-774-4050
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Authorized Official
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Title or Position | PHYSICIAN
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Name | FREDERIC C JEWETT
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Credential | DPM
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Telephone | 978-774-2628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 1718
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License Number State | MA
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