Provider Demographics
NPI:1912024514
Name:YEVICH, STEVEN JOHANNES (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOHANNES
Last Name:YEVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4023 LONG POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-5348
Mailing Address - Country:US
Mailing Address - Phone:410-349-7576
Mailing Address - Fax:
Practice Address - Street 1:4023 LONG POINT BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-5348
Practice Address - Country:US
Practice Address - Phone:410-349-7576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.0158642083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine