Individual
DR. KIMBERLY EWING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-2550
Mailing address
800 PENNSYLVIA AVENUE, CHARLESTON, WV 25302
(304) 388-2550
(304) 388-2617
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
15806
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718051
WV BCBS
WV
05
—
0106293000
—
WV
01
—
1053227
WV DWC
WV
Enumeration date
12/30/2005
Last updated
01/23/2017
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