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Individual

NICK R. EVANGELISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5260
Mailing address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5260

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004375
GA

Other

Enumeration date
05/16/2006
Last updated
12/18/2009
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