Provider Demographics
NPI:1942389390
Name:ALASYALI, EVSEN (MD)
Entity Type:Individual
Prefix:MRS
First Name:EVSEN
Middle Name:
Last Name:ALASYALI
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 1:5025 ARLINGTON CENTRE BLVD.
Mailing Address - Street 2:SUITE 500
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220
Mailing Address - Country:US
Mailing Address - Phone:314-538-8300
Mailing Address - Fax:314-538-1656
Practice Address - Street 1:5025 ARLINGTON CENTRE BLVD.
Practice Address - Street 2:SUITE 500
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220
Practice Address - Country:US
Practice Address - Phone:314-538-8300
Practice Address - Fax:314-538-1656
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350724442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000286054OtherMAGELLEN
OH2017771Medicare UPIN