Provider Demographics
NPI:1780672204
Name:YEVAK, RICHARD JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
Last Name:YEVAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:509 BILTMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4601
Mailing Address - Country:US
Mailing Address - Phone:828-213-2250
Mailing Address - Fax:828-213-2395
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-355-2372
Practice Address - Fax:704-355-6692
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88747207L00000X
NC38873207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8989628Medicaid
SCN38873OtherMEDICAID
SCSCO7075019OtherMEDICARE PIN
NC2148915BMedicare PIN