Provider Demographics
NPI:1174596266
Name:LYLES, EVELYN M (MD)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:M
Last Name:LYLES
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 1:2100 RIDGEFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2343
Mailing Address - Country:US
Mailing Address - Phone:828-670-5665
Mailing Address - Fax:828-670-5663
Practice Address - Street 1:2100 RIDGEFIELD BLVD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2343
Practice Address - Country:US
Practice Address - Phone:828-670-5665
Practice Address - Fax:828-670-5663
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29142207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
53466OtherBCBS NC
NC8953466Medicaid
0771749OtherUNITED HEALTHCARE
NC208391BMedicare ID - Type Unspecified
53466OtherBCBS NC