Individual
DR. MARK ANDREW DEWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4343 ALL SEASONS DR, STE 220, HILLIARD, OH 43026-1961
(614) 544-1100
(614) 544-1101
Mailing address
5350 FRANTZ RD, DUBLIN, OH 43016-4259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34-008401
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2637034
—
OH
Enumeration date
03/16/2006
Last updated
12/22/2021
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