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Individual
DR. JAMES ROBERT EVANS
Active
Individual
DR. JAMES ROBERT EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005352
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005148
ANTHEM
VA
01
—
12819
DORAL
VA
01
—
575810
UNITED CONCORDIA
VA
Enumeration date
04/02/2008
Last updated
04/02/2008
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