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General NPI Number Information
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NPI Number | 1528118569
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Entity Type | Individual
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Provider Name | MARIANNE J.R. MCEWEN MD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 200 HAWTHORNE LN
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City | CHARLOTTE
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State | NC
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Zip | 28204-2515
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Country | US
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Telephone | 704-384-7508
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Fax | 704-384-8666
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone | 704-384-9679
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Fax | 704-316-0508
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 200700892
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 200700892
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 036104630
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License Number State | IL
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