Individual
PAUL R DEWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2320
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65837533
—
NM
05
—
796063
—
AZ
Enumeration date
07/07/2006
Last updated
12/06/2019
Update your record
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