Individual
ERIC J EWALD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
155 HIGHWAY 50, STATELINE, NV 89449
(775) 589-8900
(775) 588-7110
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5659
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15998
NV
207Q00000X
Family Medicine Physician
A118819
CA
Other
Enumeration date
07/23/2009
Last updated
07/05/2018
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