Provider Demographics
NPI:1073868931
Name:DAVID S MCEWEN DCPA
Entity Type:Organization
Organization Name:DAVID S MCEWEN DCPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCEWEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-627-6111
Mailing Address - Street 1:2560 RCA BLVD
Mailing Address - Street 2:109
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3338
Mailing Address - Country:US
Mailing Address - Phone:561-627-6111
Mailing Address - Fax:561-627-3326
Practice Address - Street 1:2560 RCA BLVD
Practice Address - Street 2:109
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3338
Practice Address - Country:US
Practice Address - Phone:561-627-6111
Practice Address - Fax:561-627-3326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 1420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380113600Medicaid
FL89333Medicare PIN
FLT56180Medicare UPIN