Provider Demographics
NPI:1881664324
Name:INCHARDI, EVE (MD)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:
Last Name:INCHARDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:M020
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-8282
Mailing Address - Fax:269-341-8258
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:SUITE M020
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-8282
Practice Address - Fax:269-341-8258
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046722207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4177968Medicaid
MICN1148OtherRAILROAD MEDICARE
MI4177968Medicaid
MICN1148OtherRAILROAD MEDICARE