Basic Information
| Provider Information | |||||||||
| NPI: | 1083054100 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EWING | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | ERIC | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2750 CLAY EDWARDS DR STE 420 | ||||||||
| Address2: | |||||||||
| City: | NORTH KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641163258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162413338 | ||||||||
| FaxNumber: | 8169368118 | ||||||||
| Practice Location | |||||||||
| Address1: | 2750 CLAY EDWARDS DR STE 420 | ||||||||
| Address2: | |||||||||
| City: | NORTH KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162413338 | ||||||||
| FaxNumber: | 8169368118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2013 | ||||||||
| LastUpdateDate: | 07/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 2013021209 | MO | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.