Provider Demographics
NPI:1164064549
Name:DEWITT, ADAM M (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:M
Last Name:DEWITT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1545
Mailing Address - Country:US
Mailing Address - Phone:517-543-7595
Mailing Address - Fax:
Practice Address - Street 1:106 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-1545
Practice Address - Country:US
Practice Address - Phone:517-543-7595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor