Provider Demographics
NPI:1487956116
Name:EVANS, STEVEN CRAIG (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:CRAIG
Last Name:EVANS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:HATTERAS
Mailing Address - State:NC
Mailing Address - Zip Code:27943-0428
Mailing Address - Country:US
Mailing Address - Phone:252-986-2400
Mailing Address - Fax:252-986-2905
Practice Address - Street 1:57353 HWY 12 TAMS PLAZA
Practice Address - Street 2:
Practice Address - City:HATTERAS
Practice Address - State:NC
Practice Address - Zip Code:27943-0428
Practice Address - Country:US
Practice Address - Phone:252-986-2400
Practice Address - Fax:252-986-2905
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06557183500000X
VA0202009651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist