Provider Demographics
NPI:1225885841
Name:ITIYOPIYA F. EWART, PLLC
Entity type:Organization
Organization Name:ITIYOPIYA F. EWART, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ITIYOPIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:EWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-279-3020
Mailing Address - Street 1:11 REYNOLDS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-9588
Mailing Address - Country:US
Mailing Address - Phone:828-279-3020
Mailing Address - Fax:
Practice Address - Street 1:29 RAVENSCROFT DR STE 210
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3602
Practice Address - Country:US
Practice Address - Phone:828-279-3020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health