Individual
MICHAEL DEWIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
13197 STATE ROAD 23, GRANGER, IN 46530
(812) 855-8436
(812) 855-1683
Mailing address
835 N CASS ST, WABASH, IN 46992-1613
(260) 569-9550
(260) 569-0760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003973
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201367130
—
IN
Enumeration date
06/16/2016
Last updated
09/06/2023
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