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Individual

DR. GEORGE H EVANCHO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

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
213E00000X
Podiatrist
Primary
0103000375
VA
213E00000X
Podiatrist
179
NC

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
07/20/2005
Last updated
12/03/2009
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