Provider Demographics
NPI:1831395730
Name:EVITA JAMES MD PC
Entity type:Organization
Organization Name:EVITA JAMES MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVITA
Authorized Official - Middle Name:G
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACOG
Authorized Official - Phone:301-408-2799
Mailing Address - Street 1:7411 RIGGS RD
Mailing Address - Street 2:200
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-4246
Mailing Address - Country:US
Mailing Address - Phone:301-408-2799
Mailing Address - Fax:301-445-2894
Practice Address - Street 1:7411 RIGGS RD
Practice Address - Street 2:200
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-4246
Practice Address - Country:US
Practice Address - Phone:301-408-2799
Practice Address - Fax:301-445-2894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043863174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty