Individual
TIMOTHY JAMES EWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
269 GILLMAN RD STE 200B, DENVER, NC 28037-7922
(704) 316-1830
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2018-00187
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
06/30/2009
Last updated
10/27/2020
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