Provider Demographics
NPI:1336836527
Name:HEWENS, DANTE
Entity Type:Individual
Prefix:
First Name:DANTE
Middle Name:
Last Name:HEWENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NORTH EXECUTIVE PLAZA, 2320 EAST NORTH STREET
Mailing Address - Street 2:SUITE RR, ROME #104
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:864-451-2095
Mailing Address - Fax:
Practice Address - Street 1:NORTH EXECUTIVE PLAZA, 2320 EAST NORTH STREET
Practice Address - Street 2:SUITE RR, ROME #104
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-451-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0000000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health