Organization
DR. GEORGE H. EVANCHO, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE H EVANCHO D.P.M. (OWNER)
(757) 547-0123
Entity
Organization
Contact information
Practice address
632 CEDAR RD, SUITE B, CHESAPEAKE, VA 23322-8376
(757) 547-0123
(757) 547-2412
Mailing address
632 CEDAR RD, SUITE B, CHESAPEAKE, VA 23322-8376
(757) 547-0123
(757) 547-2412
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
VA- 0103000375
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211329
MAMSI
VA
01
—
358171
ANTHEM
VA
01
—
480017876
MEDICARE RAILROAD
VA
01
—
52487
OPTIMA
VA
Enumeration date
08/08/2006
Last updated
12/03/2009
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