MEDICARE: DAVID G DEWAR M.D.

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	207Q00000X	Family Medicine Physician	01043269	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC3600	OTHER	IN	RAILROAD GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	CK6957	OTHER	IN	RAILROAD GROUP
4	P00426385	OTHER	IN	RAILROAD INDIVIDUAL
5	15D0889968	OTHER	IN	CLIA
6	P00714993	OTHER	IN	RAILROAD INDIVIDUAL

General Provider Information

NPI Number	:	1770514929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID G DEWAR M.D.

Provider Business Mailing Address
First Line	:	10330 N MERIDIAN ST
Second Line	:	SUITE 201
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 SKYVIEW DR
Second Line	:
City	:	CHESTERFIELD
State	:	IN
Zip	:	46017-1057
Country	:	US
Telephone Number	:	765-378-1572
Fax Number	:	765-378-1580

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/21/2009

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Directions to “ DAVID G DEWAR M.D.” Practice Location

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