Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | OS014230 | PA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 5101019945 | MI |
NPI | 1659522324 |
---|---|
Provider Name | Dr. Joseph Edward Dewitt |
First Address | East Lansing, MI 48824-7015 |
Second Address | East Lansing, MI 48823-5306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 07/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1659522324 | (05) | MI |