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NPI Code Detail

MEDICARE: DR. GRACE ANN HEWETT MD

MEDICARE: DR. GRACE ANN HEWETT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianMD20358RI
2390200000XStudent in an Organized Health Care Education/Training Program284622MA
32085R0202XDiagnostic Radiology Physician1026285MA

General Provider Information

NPI Number : 1093331159
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GRACE ANN HEWETT MD
Provider Business Mailing Address
First Line : 125 METRO CENTER BLVD STE 2000
Second Line :
City : WARWICK
State : RI
Zip : 02886-1785
Country : US
Telephone Number : 401-432-2500
Fax Number : 401-889-3619
Provider Business Practice Location Address
First Line : 593 EDDY ST
Second Line :
City : PROVIDENCE
State : RI
Zip : 02903-4923
Country : US
Telephone Number : 401-444-5174
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2020
Last Update Date : 03/12/2026

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