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NPI Code Detail

MEDICARE: MARY J EWING SLP

MEDICARE: MARY J EWING SLP
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
1235Z00000XSpeech-Language Pathologist22003762AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619025210
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY J EWING SLP
Provider Business Mailing Address
First Line : 240 N TILLOTSON AVE
Second Line :
City : MUNCIE
State : IN
Zip : 47304-3988
Country : US
Telephone Number : 765-288-1928
Fax Number : 765-741-0335
Provider Business Practice Location Address
First Line : 14901 CAREY RD
Second Line :
City : CARMEL
State : IN
Zip : 46033-6000
Country : US
Telephone Number : 877-407-3422
Fax Number : 877-407-4329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 05/29/2024

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Directions to “ MARY J EWING SLP” Practice Location

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