Healthcare Provider Details

I. General information

NPI: 1326626722
Provider Name (Legal Business Name): EVAN NIX MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3024 NEW BERN AVE
RALEIGH NC
27610-1247
US

IV. Provider business mailing address

3024 NEW BERN AVE
RALEIGH NC
27610-1247
US

V. Phone/Fax

Practice location:
  • Phone: 919-350-7193
  • Fax:
Mailing address:
  • Phone: 919-350-7193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2026-02531
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: