MEDICARE: CAROLINE C DEWITT 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
1	207RI0200X	Infectious Disease Physician	K2151	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518957547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE C DEWITT MD

Provider Business Mailing Address
First Line	:	7940 FLOYD CURL DR STE 560
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3907
Country	:	US
Telephone Number	:	210-614-8100
Fax Number	:	210-615-7233

Provider Business Practice Location Address
First Line	:	8715 VILLAGE DR STE 514
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-5407
Country	:	US
Telephone Number	:	210-370-9922
Fax Number	:	210-545-5616

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	03/24/2025

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