Individual
PHILLIP ANDREW DEWEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 417-6000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005463
IL
363AS0400X
Surgical Physician Assistant
PAC0440
ND
363AS0400X
Surgical Physician Assistant
PENDING
OH
Other
Enumeration date
10/27/2009
Last updated
08/22/2022
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