Individual
DR. HEATHER LEIGH EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MS
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101226911
VA
2086S0102X
Surgical Critical Care Physician
Primary
61189
SC
2086S0102X
Surgical Critical Care Physician
MD60027234
WA
2086S0127X
Trauma Surgery Physician
MD60027234
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0239217
L&I
WA
05
—
1316155575
—
WA
01
—
MD60027234
WA STATE MEDICAL LICENSE
WA
Enumeration date
05/20/2007
Last updated
08/16/2018
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