Provider Demographics
NPI:1407897325
Name:JAMES, EVITA G (MD, FACOG)
Entity Type:Individual
Prefix:DR
First Name:EVITA
Middle Name:G
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 RIGGS RD
Mailing Address - Street 2:STE 200
Mailing Address - City:ADELPHI
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4246
Mailing Address - Country:US
Mailing Address - Phone:301-440-7765
Mailing Address - Fax:301-445-2894
Practice Address - Street 1:7411 RIGGS RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4246
Practice Address - Country:US
Practice Address - Phone:301-408-2799
Practice Address - Fax:301-445-2894
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043863174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405954900Medicaid
MD120271500Medicaid
MD120271500Medicaid
MDG02263Medicare ID - Type UnspecifiedGROUP #