Provider Demographics
NPI:1518957547
Name:DEWITT, CAROLINE C (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:C
Last Name:DEWITT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8042 WURZBACH RD
Mailing Address - Street 2:STE 280
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3818
Mailing Address - Country:US
Mailing Address - Phone:210-614-8100
Mailing Address - Fax:210-568-0311
Practice Address - Street 1:8715 VILLAGE DR STE 514
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5407
Practice Address - Country:US
Practice Address - Phone:210-370-9922
Practice Address - Fax:210-545-5616
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2020-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK2151207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157806401Medicaid
TX157806401Medicaid
TX8A5121Medicare ID - Type Unspecified