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General NPI Number Information
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NPI Number | 1083346688
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Entity Type | Individual
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Provider Name | EVANGELINA AMALFIS CEDENO VALDEZ MD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2022
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Last Update Date | 04/20/2025
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Provider Practice Location Address
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Address Line | 96 JONATHAN LUCAS ST CSB 822 CHARLESTON SC 29425
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City | CHARLESTON
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State | SC
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Zip | 29425-3801
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Country | US
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Telephone | 843-792-4747
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Fax |
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Provider Business Mailing Address
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Address Line | 96 JONATHAN LUCAS STREET CSB 822 CHARLESTON SC 29425
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City | CHARLESTON
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State | SC
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Zip | 29425-0001
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Country | US
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Telephone | 843-792-4747
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.079707
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License Number State | IL
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