Evans, Andrew Bennett
Evans, Andrew Bennett is an individual health care provider with primary practice located at 190 Kimel Park Dr Ste 120 , Winston Salem NC 27103-6946. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Neurophysiology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Evans, Andrew Bennett can be contacted via phone (336) 765-5553.Contact Information
Primary practice address
190 Kimel Park Dr Ste 120
Winston Salem NC 27103-6946
Phone: (336) 765-5553
Fax: (336) 765-5359
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | 2009-00162 | North Carolina |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2009-00162 | North Carolina |
Profile Details
| NPI number | 1063692721 |
|---|---|
| LBN Legal business name | Evans, Andrew Bennett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 11th, 2007 |
| Last updated | Oct 25th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063692721 | NPPES |
| North Carolina | MEDICAID | 5916410 |
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