Provider Demographics
NPI:1356395479
Name:FEWELL, JOSEPH EURANUS JR (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:EURANUS
Last Name:FEWELL
Suffix:JR
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:50 13TH AVE NE
Mailing Address - Street 2:SUITE 2-B
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-3748
Mailing Address - Country:US
Mailing Address - Phone:828-322-8380
Mailing Address - Fax:828-328-4967
Practice Address - Street 1:50 13TH AVE NE
Practice Address - Street 2:SUITE 2-B
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3748
Practice Address - Country:US
Practice Address - Phone:828-322-8380
Practice Address - Fax:828-328-4967
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2008-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC27911208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8931860Medicaid
NC203208Medicare ID - Type Unspecified
NCC81715Medicare UPIN