Provider Demographics
NPI:1588009286
Name:RICHARDS, EVAN J (MD)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:J
Last Name:RICHARDS
Suffix:
Gender:M
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:LANDSTHUL REGIONAL MEDICAL CENTER
Mailing Address - Street 2:UNIT 3310,0
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180-3100
Mailing Address - Country:US
Mailing Address - Phone:850-884-1100
Mailing Address - Fax:
Practice Address - Street 1:LANDSTHUL REGIONAL MEDICAL CENTER
Practice Address - Street 2:UNIT 3310,0
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-3100
Practice Address - Country:US
Practice Address - Phone:850-884-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256778207L00000X
AZ62619207L00000X
NV20251207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty