Organization
COVENANT EYE CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN EWING ALLF MD (PRESIDENT)
(704) 864-7789
Entity
Organization
Contact information
Practice address
2555 COURT DRIVE, SUITE 150, GASTONIA, NC 28054-2187
(704) 864-7789
(704) 864-4884
Mailing address
2555 COURT DRIVE, SUITE 150, GASTONIA, NC 28054-2187
(704) 864-7789
(704) 864-4884
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
79553
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0265Y
BCBS
NC
05
—
890265Y
—
NC
Enumeration date
04/18/2006
Last updated
03/22/2019
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