Individual
THOMAS M EWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
691 MURPHY ROAD SUITE 107, MEDFORD, OR 97504
(541) 789-6460
(541) 789-6461
Mailing address
2620 EAST BARNETT ROAD SUITE H, MEDFORD, OR 97504-8383
(541) 789-4281
(541) 789-5538
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD09781
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055962
—
OR
Enumeration date
09/14/2006
Last updated
10/05/2015
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