Individual
DR. EVA A IMPERIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
114 GATEWAY BLVD STE B, MOORESVILLE, NC 28117-5598
(980) 435-0409
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-6199
(980) 223-2378
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2010-01472
NC
207Q00000X
Family Medicine Physician
22642
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L36224
—
SC
Enumeration date
07/29/2005
Last updated
03/08/2021
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