Healthcare Provider Details

I. General information

NPI: 1891955530
Provider Name (Legal Business Name): ALLISON MICHELE GARSVA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON MICHELE EVANS DO

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 10/29/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 SUMMIT CROSSING PL STE 150
GASTONIA NC
28054-2137
US

IV. Provider business mailing address

PO BOX 744786
ATLANTA GA
30374-4786
US

V. Phone/Fax

Practice location:
  • Phone: 704-671-6300
  • Fax:
Mailing address:
  • Phone: 704-834-2450
  • Fax: 704-671-5331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS11320
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2024-02623
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: