| Doctor Name: | DR. LARRY MICHAEL DEWELL |
| NPI Number: | 1912901943 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 22243 |
| Business Practice Address: | 3207 N Academy Blvd Ste 103 Colorado Springs, CO - 809175117 |
| Business Phone Number: | 7195748383 |
| Business Fax Number: | 7195748548 |
| Mailing Address: | 3207 N Academy Blvd, Ste 103 COLORADO SPRINGS |
| State: | CO |
| Postal Code: | 809175117 |
| Phone Number: | 7195748383 |
| Fax Number: | 7195748548 |
| NPI Enumeration Date: | 06/08/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 22243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |