Provider Demographics
NPI:1760887434
Name:EVOLVE HEALTH, P.C.
Entity Type:Organization
Organization Name:EVOLVE HEALTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:UMER
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYEED-SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-934-2020
Mailing Address - Street 1:275 HANCOCK ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171-2249
Mailing Address - Country:US
Mailing Address - Phone:617-934-2020
Mailing Address - Fax:617-481-9918
Practice Address - Street 1:275 HANCOCK ST
Practice Address - Street 2:SUITE 203
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-2249
Practice Address - Country:US
Practice Address - Phone:617-934-2020
Practice Address - Fax:617-481-9918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1396966206Medicaid
MA1942314059Medicaid
MA1396966206Medicaid