Provider Demographics
NPI:1730383498
Name:MCBEAN, ETWAR H (MD)
Entity type:Individual
Prefix:DR
First Name:ETWAR
Middle Name:H
Last Name:MCBEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7500 GREENWAY CENTER DR STE 1120
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3563
Mailing Address - Country:US
Mailing Address - Phone:240-206-8506
Mailing Address - Fax:240-929-6978
Practice Address - Street 1:7500 GREENWAY CENTER DR STE 1120
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3563
Practice Address - Country:US
Practice Address - Phone:240-206-8506
Practice Address - Fax:240-929-6978
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035602208600000X
PAMD433352208600000X
FLME98540208600000X
MDD0073377208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCMD035602OtherHEALTH PROFESSIONAL LICENSING ADMINISTRATION
FLME98540OtherMEDICAL LICENSE
PAMD433352OtherDEPARTMENT OF STATE