Provider Demographics
NPI:1083346688
Name:CEDENO VALDEZ, EVANGELINA AMALFIS (MD)
Entity type:Individual
Prefix:
First Name:EVANGELINA
Middle Name:AMALFIS
Last Name:CEDENO VALDEZ
Suffix:
Gender:
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:96 JONATHAN LUCAS STREET CSB 822 CHARLESTON SC 29425
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-0001
Mailing Address - Country:US
Mailing Address - Phone:843-792-4747
Mailing Address - Fax:
Practice Address - Street 1:96 JONATHAN LUCAS ST CSB 822 CHARLESTON SC 29425
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-3801
Practice Address - Country:US
Practice Address - Phone:843-792-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.079707207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine