Provider Demographics
NPI:1629369467
Name:EVANS, DANIEL ADRIAN (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ADRIAN
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:UNM DEPARTMENT OF PSYCHIATRY
Mailing Address - Street 2:1 UNIVERSITY OF NEW MEXICO MSC09 5030
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-2223
Mailing Address - Fax:
Practice Address - Street 1:UNM DEPARTMENT OF PSYCHIATRY
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO MSC09 5030
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2014-08152084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine