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Individual

PAUL ANDREW EVANGELISTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 N SUMTER ST, SUITE 400, SUMTER, SC 29150-4916
(839) 200-7205
(803) 778-5403
Mailing address
100 N SUMTER ST, SUITE 400, SUMTER, SC 29150-4916
(839) 200-7205
(803) 778-5403

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
22833
SC
207YS0123X
Facial Plastic Surgery Physician
22833
SC
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
22833
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP2894
SC
Enumeration date
07/21/2006
Last updated
08/16/2025
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