Individual
COREY DEWITT
Active
Individual
COREY DEWITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD23389
ME
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
0101275415
VA
207ND0101X
MOHS-Micrographic Surgery Physician
D91604
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417342890
—
VA
05
—
30017465030001
—
VA
Enumeration date
04/01/2015
Last updated
11/29/2023
Update your record
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