Provider Demographics
NPI:1780736009
Name:EWERT, HOWARD T (DC)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:T
Last Name:EWERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 N PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1744
Mailing Address - Country:US
Mailing Address - Phone:413-253-9745
Mailing Address - Fax:
Practice Address - Street 1:284 N PLEASANT ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1744
Practice Address - Country:US
Practice Address - Phone:413-253-9745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA350246OtherHARVARD PILGRIM HEALTH
MAY35352OtherBLUE CROSS BLUE SHIELD
MA000509OtherTUFTS HEALTH PLANS
MA1605143Medicaid
Y35352Medicare ID - Type Unspecified