Provider Demographics
NPI:1790776763
Name:EVANS, PAUL EDWARD III (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:EDWARD
Last Name:EVANS
Suffix:III
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4107 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3729
Practice Address - Country:US
Practice Address - Phone:757-251-7977
Practice Address - Fax:757-251-7995
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2013-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101032924207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine