Individual
DR. CHARLES W HEWSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 STADIUM MALL DR, WEST LAFAYETTE, IN 47907-2052
(765) 494-1700
(765) 496-1227
Mailing address
601 STADIUM MALL DR, WEST LAFAYETTE, IN 47907-2052
(765) 494-1700
(765) 496-1227
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01035176A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000179406
ANTHEM BLUE CROSS BLUE SH
—
01
—
90784
GEISINGER HEALTH PLAN
—
Enumeration date
10/05/2005
Last updated
07/08/2007
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