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NPI Code Detail

MEDICARE: SEMIKA F EVANS

MEDICARE: SEMIKA F EVANS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOC009967PA
2225X00000XOccupational TherapistOT004067GA

General Provider Information

NPI Number : 1972535078
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEMIKA F EVANS
Provider Business Mailing Address
First Line : 2947 DELOWE DR
Second Line :
City : EAST POINT
State : GA
Zip : 30344-2307
Country : US
Telephone Number : 404-643-0552
Fax Number :
Provider Business Practice Location Address
First Line : 3090 PREMIERE PKWY STE 400
Second Line :
City : DULUTH
State : GA
Zip : 30097-8915
Country : US
Telephone Number : 877-407-3422
Fax Number : 877-407-4329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 04/23/2025

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Directions to “ SEMIKA F EVANS ” Practice Location

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