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NPI Code Detail

MEDICARE: CHRISTOPHER DAVID EWANOWSKI M.D.

MEDICARE:   CHRISTOPHER DAVID EWANOWSKI  M.D.
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
1207ND0101XMOHS-Micrographic Surgery PhysicianME100378FL
2207NS0135XProcedural Dermatology PhysicianME100378FL

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 : 1780880476
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER DAVID EWANOWSKI M.D.
Provider Business Mailing Address
First Line : 18228 N US HIGHWAY 41
Second Line :
City : LUTZ
State : FL
Zip : 33549-4400
Country : US
Telephone Number : 813-321-1786
Fax Number : 813-321-1787
Provider Business Practice Location Address
First Line : 4651 VAN DYKE RD
Second Line :
City : LUTZ
State : FL
Zip : 33558-4880
Country : US
Telephone Number : 813-321-1786
Fax Number : 813-321-1787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 10/14/2025

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Directions to “ CHRISTOPHER DAVID EWANOWSKI M.D.” Practice Location

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