Provider Demographics
NPI:1225144090
Name:DEWEER AVILES, ANN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:DEWEER AVILES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 BOULDER BROOK RD
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1019
Mailing Address - Country:US
Mailing Address - Phone:508-477-5306
Mailing Address - Fax:
Practice Address - Street 1:55 ROUTE 130
Practice Address - Street 2:
Practice Address - City:FORESTDALE
Practice Address - State:MA
Practice Address - Zip Code:02644-1402
Practice Address - Country:US
Practice Address - Phone:508-477-5306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210757208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics