Healthcare Provider Details

I. General information

NPI: 1891922514
Provider Name (Legal Business Name): ABIGAIL CATHERINE MCEWAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2009
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10860 SHELDON RD
TAMPA FL
33626-5117
US

IV. Provider business mailing address

10860 SHELDON RD
TAMPA FL
33626-5117
US

V. Phone/Fax

Practice location:
  • Phone: 813-355-8412
  • Fax: 813-355-8415
Mailing address:
  • Phone: 813-355-8412
  • Fax: 813-355-8415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2014013937
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberME165322
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: