Provider Demographics
NPI:1174710735
Name:HEWITT, STEPHAN JUSTIN ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:JUSTIN ANTHONY
Last Name:HEWITT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2555 COURT DR
Mailing Address - Street 2:STE 270
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2134
Mailing Address - Country:US
Mailing Address - Phone:704-671-7650
Mailing Address - Fax:704-671-7678
Practice Address - Street 1:2555 COURT DR
Practice Address - Street 2:STE 270
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2134
Practice Address - Country:US
Practice Address - Phone:704-671-7650
Practice Address - Fax:704-671-7678
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2020-10-25
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Provider Licenses
StateLicense IDTaxonomies
NC2010-01419207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine