Detar, Dewey Todd

Detar, Dewey Todd is an individual health care provider with primary practice located at 1595 Central Ave , Summerville SC 29483-5529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Detar, Dewey Todd can be contacted via phone (843) 212-8080.

Contact Information

Primary practice address
1595 Central Ave Summerville SC 29483-5529
Phone: (843) 212-8080
Fax: (843) 789-1521
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2020-00089 North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 483 South Carolina

Profile Details

NPI number 1750499604
LBN Legal business name Detar, Dewey Todd
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Jun 9th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750499604 NPPES
South Carolina MEDICAID 004836
South Carolina Other SC14336067
South Carolina Other SC14336084
South Carolina Other SC1433J577

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