Healthcare Provider Details

I. General information

NPI: 1073088613
Provider Name (Legal Business Name): RICHARD EVANS MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 MACARTHUR ST
ASHEBORO NC
27203-5410
US

IV. Provider business mailing address

171 MACARTHUR ST
ASHEBORO NC
27203-5410
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-2456
  • Fax: 336-625-1136
Mailing address:
  • Phone: 336-625-2456
  • Fax: 336-625-1136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: RICARD EVANS
Title or Position: OWNER
Credential: MD
Phone: 336-625-2456