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Mr. Peter Jeffrey Ewert
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NPI Number Detailed Information
Provider Information:
| Name: | Mr. Peter Jeffrey Ewert |
| Gender: | M |
| Provider License Number If Given: | 1548 |
NPI Information:
| NPI: | 1730188020 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/19/2005 |
| Last Update Date: | 7/8/2007 |
Provider Business Mailing Address:
| Address: | 6853 FAIRVIEW RD STE B Charlotte, NC 28210 |
| Phone Number: | 7043669930 |
| Fax Number: | 7043669931 |
Provider Business Practice Location Address:
| Address: | 6853 FAIRVIEW RD STE B Charlotte, NC 28210 |
| Phone Number: | 7043669930 |
| Fax Number: | 7043669931 |
Provider Taxonomy:
| Primary: | 103G00000X |
| Secondary (if any): | |
| State: | NC |
