Healthcare Provider Details

I. General information

NPI: 1053845594
Provider Name (Legal Business Name): EVELINA N PIERCE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 CENTRAL AVE STE O
DOVER NH
03820-3434
US

IV. Provider business mailing address

1162 GAINESBOROUGH DR
DALLAS GA
30157
US

V. Phone/Fax

Practice location:
  • Phone: 603-431-5205
  • Fax: 603-436-4257
Mailing address:
  • Phone: 850-240-6888
  • Fax: 850-854-8992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number33388
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: