Aylmer D Evangelista
EVANGELISTA MD PLLC


Address: 3999 Venoy Rd, Wayne, MI 48184-1485
Phone: 7347270440

Aylmer D Evangelista (NPI# 1245431659, PAC ID# 0042364499) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1245431659
PAC ID by PECOS 0042364499
Professional Enrollment ID I20090819000418
Full Name Aylmer D Evangelista
Organization Legal Name EVANGELISTA MD PLLC
Address 3999 Venoy Rd
Wayne
MI 48184-1485
Phone Number 7347270440
Gender M
Graduation Year 2003
Primary Specialty INTERNAL MEDICINE
Group Practice PAC ID 4385965292
Number of Group Practice Members 2
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
230002 ST MARY MERCY HOSPITAL
230020 BEAUMONT HOSPITAL - DEARBORN
230019 PROVIDENCE HOSP AND MED CTRS
230142 BEAUMONT HOSPITAL - WAYNE

Other Locations

Address Phone Organization
3999 Venoy Rd, Wayne, MI 48184-1485 7347270440 EVANGELISTA MD PLLC

Organization Information

Organization Legal Name EVANGELISTA MD PLLC
Physicians 1

Office Location

Street Address 3999 VENOY RD
City WAYNE
State MI
Zip 48184-1485

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Competitor

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City WAYNE
Zip Code 48184
Specialty INTERNAL MEDICINE
City + Specialty WAYNE + INTERNAL MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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