Provider Demographics
NPI:1477552339
Name:EWRY, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:EWRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:660 BEAVER CREEK CIR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1745
Mailing Address - Country:US
Mailing Address - Phone:419-891-6210
Mailing Address - Fax:419-893-3232
Practice Address - Street 1:660 BEAVER CREEK CIR
Practice Address - Street 2:SUITE 110
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1745
Practice Address - Country:US
Practice Address - Phone:419-891-6210
Practice Address - Fax:419-893-3232
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35054027207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01-03065OtherUHC
OH0651218Medicaid
OH000000141245OtherANTHEM
OH634095OtherAETNA
OH00796OtherPARAMOUNT
OH080130449OtherRRMC
OH0651218Medicaid