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Individual

DR. STEPHEN DEWITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 996-0323
(812) 996-0321
Mailing address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 996-8478
(812) 996-0214

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02001330
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000881030
BC ANTHEM ID
IN
01
02001330
INDIANA ID#
IN
05
200055720A
IN
Enumeration date
12/21/2006
Last updated
09/09/2020
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