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Individual

ALESHA J EWIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1475 W GRAND AVE, PORT WASHINGTON, WI 53074-2074
(262) 268-5100
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2960
WI
363AM0700X
Medical Physician Assistant
2960-23
WI
363AM0700X
Medical Physician Assistant
PA07902
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100040785
WI
Enumeration date
08/30/2012
Last updated
10/10/2023
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