Individual
JUDSON HOLT EVANS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 442-1100
(910) 442-1199
Mailing address
PO BOX 3686, WILMINGTON, NC 28406-0686
(910) 442-1100
(910) 442-1199
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
34307
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162106E
MEDICARE PTAN
NC
01
—
2162106G
MEDICARE PTAN
NC
05
—
893094B
—
NC
01
—
P00852717
MEDICARE RAILRAOD
NC
Enumeration date
06/16/2005
Last updated
06/03/2011
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