Healthcare Provider Details

I. General information

NPI: 1770843674
Provider Name (Legal Business Name): JOSHUA WARREN EVANS MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2012
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 HEALTH CENTER DR
AHOSKIE NC
27910-8161
US

IV. Provider business mailing address

120 HEALTH CENTER DR
AHOSKIE NC
27910-8161
US

V. Phone/Fax

Practice location:
  • Phone: 252-332-3548
  • Fax: 252-332-1665
Mailing address:
  • Phone: 252-209-0237
  • Fax: 252-209-0197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-18289
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60467204
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD91420
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2015-02244
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: