Evans, Martin T

Evans, Martin T is an individual health care provider with primary practice located at 1051 Johnston Willis Dr St 200, Richmond VA 23235. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Evans, Martin T can be contacted via phone (804) 320-2705.

Contact Information

Primary practice address
1051 Johnston Willis Dr St 200 Richmond VA 23235
Phone: (804) 320-2705
Fax: (804) 330-2433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101031974 Virginia
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 0101031974 Virginia
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 0101-031974 Virginia

Profile Details

NPI number 1700863818
LBN Legal business name Evans, Martin T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Mar 10th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700863818 NPPES
Virginia MEDICAID 7308680

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