Individual
MR. DANA ANDRE DEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 W WASHINGTON AVE, STE 150, JACKSON, MI 49201-2180
(517) 783-4664
(517) 783-4698
Mailing address
300 W WASHINGTON AVE, STE 150, JACKSON, MI 49201-2180
(517) 783-4664
(517) 783-4698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012782
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0120233
PHYSCIAN HEALTH PLAN MA
—
05
—
4080108
—
MI
01
—
700C86358
BCBS MI
—
Enumeration date
10/10/2005
Last updated
10/04/2011
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