Individual
JAMIE EVICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2115 CHAPLINE ST, WHEELING, WV 26003-3859
(304) 234-8885
(304) 234-1838
Mailing address
2115 CHAPLINE ST, WHEELING, WV 26003-3859
(304) 234-8885
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2198
WV
207R00000X
Internal Medicine Physician
34.012233
OH
207R00000X
Internal Medicine Physician
Primary
OS014252
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2198
STATE LICENSE NUMBER
WV
01
—
34.012233
STATE LICENSE NUMBER
OH
01
—
OS014252
STATE LICENSE NUMBER
PA
Enumeration date
05/07/2008
Last updated
04/06/2022
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