Individual
KEITH C HEWEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W IRONWOOD DR, SUITE 110, COEUR D ALENE, ID 83814-2656
(208) 666-3200
(208) 666-3217
Mailing address
PO BOX 1829, COEUR D ALENE, ID 83816-1829
(208) 666-3200
(208) 666-3397
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M-6804
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003724900
—
ID
01
—
1134798
CIGNA MEDICARE- RANI
ID
01
—
300068472
RR MEDICARE
ID
05
—
8218695
—
WA
01
—
B1279
BC ID - PF
ID
01
—
DD537
BC ID - RANI
ID
01
—
DD545
BC ID - CDA
ID
01
—
P00099930
RR MEDICARE - RANI
ID
Enumeration date
08/10/2005
Last updated
02/24/2012
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