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Individual

DR. CORTNEY FAITH EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
830 PENNSYLVANIA AVE, DEPARTMENT OF PEDIATRICS SUITE 104, CHARLESTON, WV 25302-3302
(304) 388-1552
Mailing address
907 CHAPPELL RD, CHARLESTON, WV 25304-2707
(304) 687-2189

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2151
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810009326
WV
Enumeration date
04/06/2007
Last updated
09/05/2019
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