Provider Demographics
NPI:1619068137
Name:TETTEH-MARTEY, EVELYN NA-ADJIELEY (MD)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:NA-ADJIELEY
Last Name:TETTEH-MARTEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 S STATE ST
Mailing Address - Street 2:APPLE MEDICAL CENTER AND URGENT CARE INC
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-7635
Mailing Address - Country:US
Mailing Address - Phone:951-925-2525
Mailing Address - Fax:951-925-6834
Practice Address - Street 1:28401 BRADLEY RD
Practice Address - Street 2:#A
Practice Address - City:SUN CITY
Practice Address - State:CA
Practice Address - Zip Code:92586
Practice Address - Country:US
Practice Address - Phone:951-679-7022
Practice Address - Fax:951-672-9541
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA81873207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A818730Medicaid
H86830Medicare UPIN
CA00A818730Medicaid