Provider Demographics
NPI:1770503765
Name:EVANS, CHARLES GARLAND JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:GARLAND
Last Name:EVANS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8001 FRANKLIN FARMS DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5108
Mailing Address - Country:US
Mailing Address - Phone:804-521-5800
Mailing Address - Fax:804-545-4340
Practice Address - Street 1:8700 STONY POINT PKWY STE 120
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1965
Practice Address - Country:US
Practice Address - Phone:804-323-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034304207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA276226OtherANTHEM/VA HEALTHKEEPERS
VA276267OtherANTHEM/VA HEALTHKEEPERS
VA276293OtherANTHEM/VA HEALTHKEEPERS
VA103815OtherANTHEM/VA HEALTHKEEPERS
VA27413300OtherFEDERAL BLACK LUNG
VA44219OtherSENTARA HEALTH/OPTIMA
VA56267OtherSOUTHERN HEALTH SERVICES
VA84510OtherANTHEM/VA HEALTHKEEPERS
VA276194OtherANTHEM/VA HEALTHKEEPERS
VA785457OtherAETNA/US HEALTHCARE HMO
VA1450519OtherCIGNA
VA6030033Medicaid
VA276349OtherANTHEM/VA HEALTHKEEPERS
VA4137154OtherAETNA/US HEALTHCARE
VA60015040OtherRAILROAD MEDICARE
VA311986OtherMAMSI
VA276267OtherANTHEM/VA HEALTHKEEPERS
VA56267OtherSOUTHERN HEALTH SERVICES