Individual provider Active NPI

Stephen F Dewitt, MD

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1932279874
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301041306 Issued in MI
Practice address
28800 Ryan Rd
Suite 230
Warren, MI 48092-4269
Phone
(586) 558-3950
Fax
(586) 558-7503
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301041306 MI Primary

Addresses

Primary practice location

28800 Ryan Rd
Suite 230
Warren, MI 48092-4269

Mailing address

28800 Ryan Rd
Suite 230
Warren, MI 48092-4269
Phone (586) 558-3950

Other identifiers 9

IdentifierTypeStateIssuer
101892762MedicaidMI
1110820001OtherMITHE WELLNESS PLAN
503683OtherMICARE CHOICES PREFERRED CH
4301041306OtherMIMI STATE LICENSE NUMBER
000000006021OtherMICAPE HEALTH PLAN
1105037461OtherMIBCBSM PIN
217178600OtherMIUSDOL-OWCP
A77875OtherMIHEALTH ALLIANCE PLAN
DR500114OtherMIM-CARE

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Internal Medicine Past Accepting new patients
University Physician Group Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1932279874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 230",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924269",
            "telephone_number": "586-558-3950",
            "fax_number": "586-558-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 230",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924269",
            "telephone_number": "586-558-3950",
            "fax_number": "586-558-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "STEPHEN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301041306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101892762",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE WELLNESS PLAN",
            "identifier": "1110820001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES PREFERRED CH",
            "identifier": "503683",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI STATE LICENSE NUMBER",
            "identifier": "4301041306",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH PLAN",
            "identifier": "000000006021",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "1105037461",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USDOL-OWCP",
            "identifier": "217178600",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "A77875",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "DR500114",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.