Provider Demographics
NPI:1053578427
Name:TWEDT, DENNIS ALAN (DO)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ALAN
Last Name:TWEDT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1909 ABERDEEN RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1393
Mailing Address - Country:US
Mailing Address - Phone:229-432-7444
Mailing Address - Fax:229-432-7445
Practice Address - Street 1:1909 ABERDEEN RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1393
Practice Address - Country:US
Practice Address - Phone:229-432-7444
Practice Address - Fax:229-432-7445
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2009-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA063038208000000X
NY247799208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics