Ewald, Roger
Ewald, Roger is an individual health care provider with primary practice located at 819 Bloomington Rd , Champaign IL 61820-2101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Ewald, Roger can be contacted via phone (217) 403-5401.Contact Information
Primary practice address
819 Bloomington Rd
Champaign IL 61820-2101
Phone: (217) 403-5401
Fax: (217) 366-0160
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 036043360 | Illinois |
Profile Details
| NPI number | 1598908733 |
|---|---|
| LBN Legal business name | Ewald, Roger |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 17th, 2009 |
| Last updated | Apr 17th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598908733 | NPPES |
| Illinois | Other | 036043360 | LICENSEE PHYSICIAN AND SURGEON |
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