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Individual

MR. EDWARD M EWALD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13 CHURCH RD, EAST GRANBY, CT 06026-0518
(860) 653-4526
(860) 653-5209
Mailing address
PO BOX 518, 13 CHURCH RD, EAST GRANBY, CT 06026-0518
(860) 653-4526
(860) 653-5209

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
018024
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00118024900
BLUECARE FAMILY
CT
01
010018024CT01
BCBS
CT
01
0104405
UNITED
CT
01
0204022002
CIGNA
CT
01
0P0373
HEALTHNET
CT
01
140066
AETNA
CT
01
781463
CT
CT
01
HAP209
OXFORD
CT
Enumeration date
12/29/2005
Last updated
07/08/2007
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