Individual
EDGAR J EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2110 E FLAMINGO RD STE 201, LAS VEGAS, NV 89119-5192
(702) 800-7831
(877) 409-2014
Mailing address
1452 W HORIZON RIDGE PKWY # 566, HENDERSON, NV 89012-4422
(702) 800-7831
(877) 409-2014
Taxonomy
Speciality
Code
Description
License number
State
2084D0003X
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
12377
NV
2084N0400X
Neurology Physician
12377
NV
2084N0600X
Clinical Neurophysiology Physician
Primary
12377
NV
Other
Enumeration date
05/02/2007
Last updated
05/22/2024
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