Provider Demographics
NPI:1619984473
Name:EVANS, MICHAEL RAND (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RAND
Last Name:EVANS
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 1:526 S HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5400
Mailing Address - Country:US
Mailing Address - Phone:406-457-1977
Mailing Address - Fax:
Practice Address - Street 1:1892 WILLIAMS ST
Practice Address - Street 2:FORT HARRISON V.A. MEDICAL CENTER
Practice Address - City:FORT HARRISON
Practice Address - State:MT
Practice Address - Zip Code:59636
Practice Address - Country:US
Practice Address - Phone:406-442-6410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23246208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery