Provider Demographics
NPI:1689118291
Name:EV HEALTHCARE, LLC
Entity Type:Organization
Organization Name:EV HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/PCP
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMAR
Authorized Official - Middle Name:AVATAR
Authorized Official - Last Name:ADOLEMAIU-BEY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP, DNP
Authorized Official - Phone:443-216-9779
Mailing Address - Street 1:1045 TAYLOR AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-8331
Mailing Address - Country:US
Mailing Address - Phone:443-261-6130
Mailing Address - Fax:410-946-1925
Practice Address - Street 1:1045 TAYLOR AVE STE 210
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-8331
Practice Address - Country:US
Practice Address - Phone:443-261-6130
Practice Address - Fax:410-946-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR165813261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care