Provider Demographics
NPI:1033182217
Name:EVANS, ADRIENNE COKER (MD)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:COKER
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ADRIENNE
Other - Middle Name:SHAVONNE
Other - Last Name:COKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8420 UNIVERSITY EXECUTIVE PARK DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262
Mailing Address - Country:US
Mailing Address - Phone:704-316-1750
Mailing Address - Fax:704-316-1755
Practice Address - Street 1:8420 UNIVERSITY EXECUTIVE PARK DRIVE
Practice Address - Street 2:SUITE 850
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262
Practice Address - Country:US
Practice Address - Phone:704-316-1750
Practice Address - Fax:704-316-1755
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100336207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129YUMedicaid
NC2294793BMedicare PIN
NC89129YUMedicaid