Provider Demographics
NPI:1033284930
Name:EVANS, EUGENE LUDWIG JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:LUDWIG
Last Name:EVANS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:19 CARLISLE DR
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3820
Mailing Address - Country:US
Mailing Address - Phone:973-758-0044
Mailing Address - Fax:973-758-0055
Practice Address - Street 1:2 W NORTHFIELD RD
Practice Address - Street 2:SUITE 211
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3789
Practice Address - Country:US
Practice Address - Phone:973-758-0044
Practice Address - Fax:973-758-0055
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06972500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ044862Medicare ID - Type Unspecified
NJF96513Medicare UPIN