MEDICARE: MRS. EUGENIA KEVELYUK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	MD452981	PA
2	207R00000X	Internal Medicine Physician	MD452981	PA

General Provider Information

NPI Number	:	1073801502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EUGENIA KEVELYUK M.D.

Provider Business Mailing Address
First Line	:	25 HEATHER VALLEY RD
Second Line	:
City	:	SOUTHAMPTON
State	:	PA
Zip	:	18966-2634
Country	:	US
Telephone Number	:	347-782-6677
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 HEATHER VALLEY RD
Second Line	:
City	:	SOUTHAMPTON
State	:	PA
Zip	:	18966-2634
Country	:	US
Telephone Number	:	347-782-6677
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2011
Last Update Date	:	03/20/2026

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