Provider Demographics
NPI:1679712152
Name:HEWITT, ELIZABETH ANNE (DPM)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:HEWITT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 STRINGTOWN RD STE 220
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8911
Mailing Address - Country:US
Mailing Address - Phone:614-782-3668
Mailing Address - Fax:614-782-3674
Practice Address - Street 1:1325 STRINGTOWN RD STE 220
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8911
Practice Address - Country:US
Practice Address - Phone:614-782-3668
Practice Address - Fax:614-782-3674
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003510213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00961306OtherMEDICARE RAILROAD
OH3018488Medicaid
OH3018488Medicaid
OH0433310005Medicare NSC
OH0433310002Medicare NSC
OH9929221Medicare PIN
OH0433310004Medicare NSC
OH0433310006Medicare NSC
OHP00961306OtherMEDICARE RAILROAD
OH4271041Medicare PIN
OH9929223Medicare PIN