Individual
DR. BRIAN RANDALL EWY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
21 RIVERS EDGE DR, KENNEBUNK, ME 04043-7739
(207) 967-2745
Mailing address
23625 COMMERCE PARK, STE 204, BEACHWOOD, OH 44122-5845
(216) 255-5743
(866) 735-3451
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
1835
ME
2085R0202X
Diagnostic Radiology Physician
58575
TN
2085R0202X
Diagnostic Radiology Physician
OS015362
PA
2085R0202X
Diagnostic Radiology Physician
OS9950
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025758980002
—
PA
01
—
1205878857
TRICARE NORTH
—
05
—
1415863
—
LA
05
—
432215499
—
ME
05
—
7100081200
—
KY
05
—
7617011
—
NC
05
—
Q01835
—
SC
Enumeration date
06/11/2006
Last updated
01/28/2025
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