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Individual
ANGELA FAYE DEWEESE
Active
Individual
ANGELA FAYE DEWEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01047130A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000318862
ANTHEM
IN
05
—
200116780
—
IN
01
—
64075823
KY MEDICAID
KY
Enumeration date
12/01/2006
Last updated
01/03/2013
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