Victor Alan Dewyea, M.D.
Individual provider Active NPI Allergy Physician · Fort Eisenhower, GA
NPI 1962570481 · NPPES record last updated May 29, 2024
Key facts
- NPI
- 1962570481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Allergy Physician 207KA0200X
- License
- 200000204 (NC)
- Practice address
- 300 W Hospital Rd FL 8
Fort Eisenhower, GA 30905-5741 - Phone
- (706) 787-4154
- Fax
- (706) 787-2554
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160126000217 | GA | Order and Referring Only - Allergy/Immunology |
4688748403 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200000204 | NC | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rex Hospital, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology (Internal Medicine) Physician | 207RA0201X | 200000204 | NC | |
| Hospitalist Physician | 208M00000X | 200000204 | NC | |
| Allergy Physician | 207KA0200X | 200000204 | NC | Yes |
Addresses
Primary practice location
300 W Hospital Rd FL 8
Fort Eisenhower, GA 30905-5741
Mailing address
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Phone (706) 787-4154
Other providers in Fort Eisenhower, GA
- John Michael Curtin
- Sherie Lenell Davis
- Kelly Davison
- Michael J Day
- Carolina Marcia Delgado
- Dustin Donofry
- Gretchen Dowdy
- Harrison Elliott Williams Duckett
- Wendy K. F. Dwigans
- Mary Ellen Earwood
All providers in Fort Eisenhower, GA · Allergy Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.