Ross, Evan M

Ross, Evan M is an individual health care provider with primary practice located at 1506 Ne Williamson Blvd , Bend OR 97701-6071. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Ross, Evan M can be contacted via phone (541) 383-3668.

Contact Information

Primary practice address
1506 Ne Williamson Blvd Bend OR 97701-6071
Phone: (541) 383-3668
Fax: (541) 383-4546
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X DP198503 Oregon
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 00448 Kentucky

Profile Details

NPI number 1972913069
LBN Legal business name Ross, Evan M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 29th, 2014
Last updated Sep 12th, 2023 - about 3 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 1972913069 NPPES
Indiana MEDICAID 201394010
Indiana MEDICAID 7100417980
Indiana Other P01673048
Indiana Other 50111319
Indiana Other 000001024410

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