Provider Demographics
NPI:1457249526
Name:EWALD, TODD
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:EWALD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 6TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-6812
Mailing Address - Country:US
Mailing Address - Phone:402-429-5645
Mailing Address - Fax:
Practice Address - Street 1:1116 10TH AVE STE A
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-2001
Practice Address - Country:US
Practice Address - Phone:308-524-5573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider