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Organization

HIGH CREST MEDICAL, LLC

Active
Other names
High Crest Health
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EUGENE L EVANS II MD (PHYSICIAN)
(973) 808-5550
Entity
Organization

Contact information

Practice address
50 FAIRFIELD RD, FAIRFIELD, NJ 07004-2414
(973) 808-5550
(973) 808-5999
Mailing address
50 FAIRFIELD RD, FAIRFIELD, NJ 07004-2414
(973) 808-5550
(973) 808-5999

Taxonomy

Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
207RS0010X
Sports Medicine (Internal Medicine) Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
044862WGE
MEDICARE RENDERING PROVIDER NUMBER
NJ
Enumeration date
10/08/2009
Last updated
10/08/2009
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