Provider Demographics
NPI:1649290784
Name:MCELWEE, EUGENE T JR (DO)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:T
Last Name:MCELWEE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 BULLDOG BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3188
Mailing Address - Country:US
Mailing Address - Phone:321-725-7225
Mailing Address - Fax:321-308-0635
Practice Address - Street 1:801 WELLNESS WAY STE 200
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3783
Practice Address - Country:US
Practice Address - Phone:772-581-5581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006648L207Q00000X
FLOS18207207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100460OtherGEISINGER
PA997600OtherHIGHMARK BLUE SHIELD
PA30096358OtherAMERIHEALTH MERCY-WMG
PA50062684OtherCAPITAL BLUE CROSS-WMG
PA205438OtherJOHNS HOPKINS
PA101393916Medicaid
PA20057319OtherAMERIHEALTH MERCY-WMG
PA5998517OtherAETNA
MD889362OtherCAREFIRST MD BCBS
PA188404OtherUNISON-WMG
PA0277110000OtherAMERIHEALTH 65 PA
PA1544893OtherGATEWAY-WMG
PA2161250OtherMAMSI-WMG
PA30096358OtherAMERIHEALTH MERCY-WMG
PA5998517OtherAETNA