Organization
JOSE S EVANGELISTA III MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE S EVANGELISTA III MD (OWNER)
(248) 890-9995
Entity
Organization
Contact information
Practice address
7071 ORCHARD LAKE RD, SUITE 333, WEST BLOOMFIELD, MI 48322-3613
(248) 890-9995
Mailing address
7071 ORCHARD LAKE RD, SUITE 333, WEST BLOOMFIELD, MI 48322-3613
(248) 890-9995
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
05865R
MI
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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