Provider Demographics
NPI:1235585233
Name:VITIELLO, EVAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:MICHAEL
Last Name:VITIELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:GENERAL PSYCHIATRY RESIDENCY TRAINING
Mailing Address - Street 2:CB# 7160, G0204 NEUROSCIENCES HOSPITAL
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7160
Mailing Address - Country:US
Mailing Address - Phone:984-974-2194
Mailing Address - Fax:
Practice Address - Street 1:194 FINLEY GOLF COURSE RD STE 104
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4401
Practice Address - Country:US
Practice Address - Phone:984-215-5151
Practice Address - Fax:984-215-5161
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2180072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry