Dewitt, Corey
Dewitt, Corey is an sole proprietor health care provider with primary practice located at 19465 Deerfield Avenue, Suite 401 , Leesburg VA 20176-1707. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Dewitt, Corey can be contacted via phone (703) 723-5700.Contact Information
Primary practice address
19465 Deerfield Avenue, Suite 401
Leesburg VA 20176-1707
Phone: (703) 723-5700
Fax: (703) 723-5778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | MD23389 | Maine |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | D91604 | Maryland |
| Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery | 207ND0101X | 0101275415 | Virginia |
Profile Details
| NPI number | 1417342890 |
|---|---|
| LBN Legal business name | Dewitt, Corey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 1st, 2015 |
| Last updated | Nov 29th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417342890 | NPPES |
| Virginia | MEDICAID | 30017465030001 | |
| Virginia | MEDICAID | 1417342890 |
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