Active NPI
Barry Dewitt, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Fenton, MI
National Provider Identifier
1649630435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 4301035353
- Practice address
- 11345 Greenview Dr
Fenton, MI 48430-2591 - Phone
- (810) 629-3766
- NPI assigned
- Mar 7, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 4301035353 | MI | Primary |
Addresses
Primary practice location
11345 Greenview Dr
Fenton, MI 48430-2591
Mailing address
11345 Greenview Dr
Fenton, MI 48430-2591
Phone (810) 629-3766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301035353 | MI | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457308800000",
"number": "1649630435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11345 GREENVIEW DR",
"city": "FENTON",
"state": "MI",
"postal_code": "484302591",
"telephone_number": "810-629-3766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11345 GREENVIEW DR",
"city": "FENTON",
"state": "MI",
"postal_code": "484302591",
"telephone_number": "810-629-3766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWITT",
"first_name": "BARRY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-07",
"last_updated": "2016-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MI",
"license": "4301035353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.