Individual provider · Type 1 NPI

Fred Carter Ewalt, PA

Medical Physician Assistant · Jacksonville, FL

NPI number 1487629267 Active

Practice location

2080 Child St
Jacksonville, FL 32214-5005

Call (904) 542-7765 Map

Fax (904) 542-7835

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X1462446 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1487629267

Fred Carter Ewalt, PA's National Provider Identifier is 1487629267, issued on Feb 23, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Jacksonville, FL. The record was last updated on Nov 10, 2009.