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Individual

STEPHEN DEWAN

Active
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Individual

STEPHEN DEWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
F5518
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117733902
—
TX
01
—
741796484
TAX ID NO
TX
01
—
824101
AUSTIN BCBS PROV NO
TX
01
—
85004X
SAN ANGELO BCBS PROV NO
TX
Enumeration date
07/27/2006
Last updated
07/30/2009
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