Healthcare Provider Details

I. General information

NPI: 1184683294
Provider Name (Legal Business Name): CHRISTOPHER SCOTT BEWLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 VAIL AVE
CHARLOTTE NC
28207-1248
US

IV. Provider business mailing address

1815 BROWNING AVE
CHARLOTTE NC
28205-3549
US

V. Phone/Fax

Practice location:
  • Phone: 704-304-5000
  • Fax:
Mailing address:
  • Phone: 310-663-7458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number84749
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101235900
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA108317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: