MR. DANA ANDRE DEWITT DO NPI 1124016639

NPI Information

  • NPI: 1124016639
  • Provider Name: MR. DANA ANDRE DEWITT, DO
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 300 W WASHINGTON AVE
    STE 150
    JACKSON, MI
    ZIP 49201
  • Phone: (517) 783-4664

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NPI Details

MR. Dana Andre Dewitt, DO is a family medicine in Jackson, MI with 31 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MR. Dana Andre Dewitt, DO NPI is 1124016639. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:1995

The provider's business location address is:

300 W WASHINGTON AVE
STE 150
JACKSON, MI
ZIP 49201-180
Phone: (517) 783-4664
Fax: (517) 783-4698

The NPI 1124016639 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/10/2005 and was last updated on 10/4/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine5101012782MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10120233OTHERPHYSCIAN HEALTH PLAN MA
2G39231MEDICARE UPIN
386358006MEDICARE ID-TYPE UNSPECIFIED
4700C86358OTHERBCBS MI
54080108MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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