Evans, Evan

Evans, Evan is an individual health care provider with primary practice located at 1150 Youngs Rd , Williamsville NY 14221-8053. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Evans, Evan can be contacted via phone (716) 636-9004.

Contact Information

Primary practice address
1150 Youngs Rd Williamsville NY 14221-8053
Phone: (716) 636-9004
Fax: (716) 636-0132
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 126194 New York

Profile Details

NPI number 1285617431
LBN Legal business name Evans, Evan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285617431 NPPES
New York MEDICAID 0598123

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