Basic Information
Provider Information
NPI: 1235447178
EntityType: 2
ReplacementNPI:  
OrganizationName: MCEWAN EMERGENCY PHYSICIANS
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Mailing Information
Address1: 815 S PALAFOX ST
Address2: SUITE 300
City: PENSACOLA
State: FL
PostalCode: 325025960
CountryCode: US
TelephoneNumber: 8004447009
FaxNumber: 8003053233
Practice Location
Address1: 703 N MCEWAN ST
Address2:  
City: CLARE
State: MI
PostalCode: 486171440
CountryCode: US
TelephoneNumber: 9898025000
FaxNumber: 9898025120
Other Information
ProviderEnumerationDate: 09/14/2010
LastUpdateDate: 09/14/2010
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AuthorizedOfficialLastName: TAYLOR
AuthorizedOfficialFirstName: JOSEPH
AuthorizedOfficialMiddleName: W
AuthorizedOfficialTitleorPosition: EXEC VICE PRES, EPP, GENERAL PARTNR
AuthorizedOfficialTelephone: 8004447009
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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