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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

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