Provider Demographics
NPI:1851356588
Name:HEWARD, JOSEPH DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DAVID
Last Name:HEWARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:HEWARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:50 BOULDER WAY
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9442
Mailing Address - Country:US
Mailing Address - Phone:207-286-2020
Mailing Address - Fax:207-286-2022
Practice Address - Street 1:50 BOULDER WAY
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9442
Practice Address - Country:US
Practice Address - Phone:207-286-2020
Practice Address - Fax:207-286-2022
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT568152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1073773487OtherGROUP NPI
ME1851356588OtherDAVID HEWARD INDIVIDUAL NPI
ME263470099Medicaid
T31703Medicare UPIN
ME1073773487OtherGROUP NPI
MEDP3562Medicare PIN
ME0006700Medicare PIN