Provider Demographics
NPI:1962570481
Name:DEWYEA, VICTOR ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ALAN
Last Name:DEWYEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:300 W HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:FORT EISENHOWER
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5741
Mailing Address - Country:US
Mailing Address - Phone:706-787-4154
Mailing Address - Fax:706-787-2554
Practice Address - Street 1:300 W HOSPITAL RD FL 8
Practice Address - Street 2:
Practice Address - City:FORT EISENHOWER
Practice Address - State:GA
Practice Address - Zip Code:30905-5741
Practice Address - Country:US
Practice Address - Phone:706-787-4154
Practice Address - Fax:706-787-2554
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000204207RA0201X, 208M00000X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist