Provider Demographics
NPI:1679538714
Name:JEWETT, FREDERIC C (DPM)
Entity Type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:C
Last Name:JEWETT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7 FEDERAL ST
Mailing Address - Street 2:SUITE 33
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3620
Mailing Address - Country:US
Mailing Address - Phone:978-774-2628
Mailing Address - Fax:978-774-4050
Practice Address - Street 1:7 FEDERAL ST
Practice Address - Street 2:33
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3620
Practice Address - Country:US
Practice Address - Phone:978-774-2628
Practice Address - Fax:978-774-4050
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1718213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA32535OtherFALLON
MAY70806OtherBLUE CROSS
MA721340OtherTUFTS/SH
MA33381OtherFIRST SENIORITY
MA33381OtherHP/HPF
MA94137OtherAETNA USHC
MA2700223OtherUHC
MAJEY77148OtherGROUP ME&BC
MAY70806OtherBLUE CROSS