Individual
MARIANNE J.R. MCEWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-7508
(704) 384-8666
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-9679
(704) 316-0508
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
200700892
NC
2080P0203X
Pediatric Critical Care Medicine Physician
036104630
IL
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
200700892
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036104630
—
IL
05
—
5908437
—
NC
Enumeration date
01/11/2007
Last updated
02/20/2013
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