Provider Demographics
NPI:1326346503
Name:EVANS, DAVID MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:EVANS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:640 ULUKAHIKI ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4454
Mailing Address - Country:US
Mailing Address - Phone:719-526-7000
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY - ATTN. DAVID EVANS
Practice Address - City:MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859
Practice Address - Country:US
Practice Address - Phone:808-433-6031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDOS17832085R0202X
NE7862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology