Provider Demographics
NPI:1427084722
Name:DREYFUS, EVE MICHELE (MD)
Entity type:Individual
Prefix:DR
First Name:EVE
Middle Name:MICHELE
Last Name:DREYFUS
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 1:12728 VIA FELINO
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-3806
Mailing Address - Country:US
Mailing Address - Phone:219-713-4997
Mailing Address - Fax:858-461-0435
Practice Address - Street 1:301 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6211
Practice Address - Country:US
Practice Address - Phone:574-647-8470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070946A2084P0800X, 2084P0804X
CAA464472084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201068410Medicaid
IN000000932966OtherBCBS BMG BEHAVIORAL ELKHART
IN000000932966OtherBCBS BMG BEHAVIORAL ELKHART
IN000000768976OtherBCBS BMG SOUTH BEND
IN000000932966OtherBCBS BMG BEHAVIORAL ELKHART