Individual
BRYAN EDWARD JEWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027-2684
(262) 670-4000
(262) 670-4091
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
49857
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34737300
—
WI
05
—
89136UT
—
NC
Enumeration date
08/30/2006
Last updated
11/04/2024
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