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Individual

DR. MARY PALMQUIST EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
210 ELM AVE, LOUISA, VA 23093-6578
(434) 242-7077
Mailing address
PO BOX 6126, CHARLOTTESVILLE, VA 22901-6126
(434) 242-7077

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101233405
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010155827
VA
Enumeration date
03/16/2006
Last updated
04/01/2009
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