Michael Wayne Dewey, RPH
Individual provider Active NPI Pharmacist · Twin Valley, MN
NPI 1871715318 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1871715318
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 112180 (MN)
- Practice address
- 207 Lincoln Ave. N.E.
Twin Valley, MN 56584 - Phone
- (218) 584-5377
- Fax
- (218) 584-8340
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112180 | MN | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 112180 | MN | Yes |
Addresses
Primary practice location
207 Lincoln Ave. N.E.
Twin Valley, MN 56584
Mailing address
207 Lincoln Ave N.E.
P.O. Box 427
Twin Valley, MN 56584-0427
Phone (218) 584-5377
Other providers in Twin Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.