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NPI Code Detail

MEDICARE: DR. EVAN MALCOLM TORCH MD

MEDICARE:  DR. EVAN MALCOLM TORCH  MD
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
12084P0800XPsychiatry Physician19462GA

General Provider Information

NPI Number : 1528283736
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVAN MALCOLM TORCH MD
Provider Business Mailing Address
First Line : 6075 LAKE FORREST DR NW STE 210
Second Line :
City : ATLANTA
State : GA
Zip : 30328-3845
Country : US
Telephone Number : 404-255-7447
Fax Number : 404-255-7044
Provider Business Practice Location Address
First Line : 6075 LAKE FORREST DR NW STE 210
Second Line :
City : ATLANTA
State : GA
Zip : 30328-3845
Country : US
Telephone Number : 404-255-7447
Fax Number : 404-255-7044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 07/08/2007

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Directions to “ DR. EVAN MALCOLM TORCH MD” Practice Location

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