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NPI Code Detail

MEDICARE: DR. KIMBERLY EWING MD

MEDICARE: DR. KIMBERLY EWING MD
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
1207P00000XEmergency Medicine Physician15806WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1001718051OTHERWVWV BCBS
21053227OTHERWVWV DWC
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265419279
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY EWING MD
Provider Business Mailing Address
First Line : 800 PENNSYLVIA AVENUE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302
Country : US
Telephone Number : 304-388-2550
Fax Number : 304-388-2617
Provider Business Practice Location Address
First Line : 800 PENNSYLVANIA AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-3351
Country : US
Telephone Number : 304-388-2550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 01/23/2017

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