Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101019845 | VA |
NPI | 1003861360 |
---|---|
Provider Name | Dr. Gerald W. Dewitt |
First Address | Arrington, VA 22922 |
Second Address | Arrington, VA 22922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 28/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010123879 | (05) | VA |
010123879 | VA PREMIERE HELTH PLAN (01) | |
12-00465 | UNITED HEALTHCARE (01) | |
1485127009 | CIGNA (01) | |
154019 | ANTHEM (01) | |
2177792 | AETNA HMO (01) | |
249647 | SOUTHERN HEALTH (01) | |
4305649 | AETNA TRADITIONAL (01) | |
53854 | SENTARA/OPTIMA (01) | |
54-1778786 | CCN (01) | |
54-1778786 | FIRST HEALTH/MAIL HANDLER (01) | |
54-1778786 | MID ATLANTIC HEALTH SOLUT (01) | |
54-1778786 | PHCS (01) | |
54-1778786 | VA HEALTH NETWORK (01) | |
54-1778786-032 | CHAMPUS/TRICARE (01) | |
8128043 | MAMSI/MDIPA (01) | |
B65360 | (02) |