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NPI Code Detail

MEDICARE: MATTHEW B DEWYS DO

MEDICARE: MATTHEW B DEWYS DO
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
1207PE0004XEmergency Medical Services (Emergency Medicine) Physician5101009537MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00363193OTHERMIRAILROAD MEDICARE

General Provider Information

NPI Number : 1427151083
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW B DEWYS DO
Provider Business Mailing Address
First Line : 2537 MOMENTUM PL
Second Line :
City : CHICAGO
State : IL
Zip : 60689-5325
Country : US
Telephone Number : 616-975-1845
Fax Number : 616-285-0846
Provider Business Practice Location Address
First Line : 615 S BOWER ST
Second Line :
City : GREENVILLE
State : MI
Zip : 48838-2614
Country : US
Telephone Number : 616-754-4341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2006
Last Update Date : 09/13/2011

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