| Doctor Name: | MARK WILLIAM DEWEY |
| NPI Number: | 1134253750 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHARM.D., CGP |
| License Number: | 116779-3 |
| Business Practice Address: | 712 S Cascade St Lake Region Healthcare Corp Fergus Falls, MN - 565372913 |
| Business Phone Number: | 2187368057 |
| Business Fax Number: | |
| Mailing Address: | 23050 Birchwood Estates Rd, FERGUS FALLS |
| State: | MN |
| Postal Code: | 565374518 |
| Phone Number: | 2187368057 |
| Fax Number: | 2187368787 |
| NPI Enumeration Date: | 03/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835G0303X |
| License Number: | 116779-3 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Geriatric |
| Taxonomy Definition: | A pharmacist who is certified in geriatric pharmacy practice is designated as a |