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Individual

CHARLES LEE EWELL JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 341-5779
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
(910) 341-5779

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
30982
NC
207RA0401X
Addiction Medicine (Internal Medicine) Physician
30982
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
136AP
BCBS
NC
05
89136AP
NC
01
P000950685
RAILROAD MEDICARE
NC
Enumeration date
05/15/2006
Last updated
04/21/2023
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