Provider Demographics
NPI:1437186228
Name:MCEWEN, CHRISTOPHER JAMES (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:MCEWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 FLANDERS DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808
Mailing Address - Country:US
Mailing Address - Phone:225-766-5151
Mailing Address - Fax:225-766-8216
Practice Address - Street 1:5220 FLANDERS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-766-5151
Practice Address - Fax:225-766-8216
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015298207N00000X, 207NP0225X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1350656Medicaid
50476Medicare ID - Type Unspecified
B89337Medicare UPIN