Individual
EVGENIY ANATOLIY KOSHKAROV
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) 667-7000
Mailing address
PO BOX 9025, WILMINGTON, NC 28402-9025
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
RTL24-0243
NC
2084P0800X
Psychiatry Physician
Primary
2024-02749
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2023
Last updated
09/04/2025
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