Provider Demographics
NPI:1053845594
Name:PIERCE, EVELINA N (MD)
Entity type:Individual
Prefix:
First Name:EVELINA
Middle Name:N
Last Name:PIERCE
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 1:1162 GAINESBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157
Mailing Address - Country:US
Mailing Address - Phone:850-240-6888
Mailing Address - Fax:850-854-8992
Practice Address - Street 1:2 MANHATTANVILLE RD
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2113
Practice Address - Country:US
Practice Address - Phone:800-835-2362
Practice Address - Fax:850-854-8992
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL37744207N00000X, 208D00000X
GA92202207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice