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NPI Code Detail

MEDICARE: NEIL ROBERT EWING PA-C

MEDICARE: NEIL ROBERT EWING PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant2429MA
2363A00000XPhysician Assistant0010-06623NC

General Provider Information

NPI Number : 1023297546
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEIL ROBERT EWING PA-C
Provider Business Mailing Address
First Line : PO BOX 63362
Second Line :
City : CHARLOTTE
State : NC
Zip : 28263-3362
Country : US
Telephone Number : 800-782-6945
Fax Number :
Provider Business Practice Location Address
First Line : 4709 CREEKSTONE DR
Second Line :
City : DURHAM
State : NC
Zip : 27703-9822
Country : US
Telephone Number : 919-660-2217
Fax Number : 919-660-5022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2007
Last Update Date : 09/23/2016

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