Provider Demographics
NPI:1053845594
Name:PIERCE, EVELINA N (MD)
Entity Type:Individual
Prefix:
First Name:EVELINA
Middle Name:N
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:835 COGBURN AVENUE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1010
Mailing Address - Country:US
Mailing Address - Phone:770-422-8815
Mailing Address - Fax:770-422-8816
Practice Address - Street 1:850 CHARLES HARDY PARKWAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-3163
Practice Address - Country:US
Practice Address - Phone:770-336-8888
Practice Address - Fax:770-336-7406
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2022-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL37744207N00000X, 208D00000X
GA92202207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice