Organization
MARY P EVANS MD PLC
Active
Other names
Blue Ridge Long Term Care Associates, PLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PALMQUIST EVANS M.D. (PRESIDENT)
(434) 242-7077
Entity
Organization
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
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
0101233405
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010155827
—
VA
Enumeration date
03/14/2006
Last updated
04/01/2009
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