Individual
DR. EVAN J FLIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 HAWTHORNE AVE STE P, ATHENS, GA 30606-2168
(706) 546-5340
(706) 546-5603
Mailing address
1000 HAWTHORNE AVE STE P, ATHENS, GA 30606-2168
(706) 546-5340
(706) 546-5603
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
033964
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000449677B
—
GA
01
—
11D0987536
CLIA NUMBER
GA
Enumeration date
05/31/2006
Last updated
04/30/2019
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