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Individual

DONAVON L WEWERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1118 ROSS CLARK CIR, SUITE 100, DOTHAN, AL 36301-3001
(334) 794-1148
(334) 793-1954
Mailing address
1118 ROSS CLARK CIR, SUITE 100, DOTHAN, AL 36301-3001
(334) 794-1148
(334) 793-1954

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00024467
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051516124
AL
01
51516124
BCBS
AL
01
P00055040
RAILROAD MEDICARE
AL
Enumeration date
05/23/2006
Last updated
01/12/2010
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