Individual
AVERY J. EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0001
(434) 924-9400
(434) 982-1618
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
0101051039
VA
2085R0204X
Vascular & Interventional Radiology Physician
0101051039
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841200078
—
VA
Enumeration date
08/09/2006
Last updated
10/27/2020
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