Provider Demographics
NPI:1891783403
Name:DEWEY, TODD M (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:M
Last Name:DEWEY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1320 GREENWAY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2550
Mailing Address - Country:US
Mailing Address - Phone:972-550-9195
Mailing Address - Fax:972-550-0079
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:A323
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-566-4866
Practice Address - Fax:972-490-5457
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2022-01-19
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Provider Licenses
StateLicense IDTaxonomies
TXH9884208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
F58837Medicare UPIN