| Paul Hewitt Llc | |
|
4131 Embassy Dr Se Grand Rapids MI 49546-2418 | |
| (616) 551-4694 | |
| Not Available |
| Full Name | Paul Hewitt Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4131 Embassy Dr Se, Grand Rapids, Michigan |
| Authorized Official Name and Position | Paul S Hewitt (OWNER) |
| Authorized Official Contact | 6165514694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul Hewitt Llc 4131 Embassy Dr Se Grand Rapids MI 49546-2418 Ph: (616) 551-4694 | Paul Hewitt Llc 4131 Embassy Dr Se Grand Rapids MI 49546-2418 Ph: (616) 551-4694 |
| NPI Number | 1649660952 |
|---|---|
| Provider Enumeration Date | 01/26/2015 |
| Last Update Date | 01/26/2015 |
| Medicare PECOS PAC ID | 8729303698 |
|---|---|
| Medicare Enrollment ID | O20150217001930 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649660952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301013946 (Michigan) | Primary |
| Provider Name | Paul S Hewitt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851549745 PECOS PAC ID: 4183816135 Enrollment ID: I20101008000125 |
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