Provider Demographics
NPI:1336149186
Name:EVANS, STEVEN MARK (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARK
Last Name:EVANS
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Gender:M
Credentials:DO
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Mailing Address - Street 1:2607 KEISER BOULEVARD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:484-509-0840
Mailing Address - Fax:610-678-2100
Practice Address - Street 1:2607 KEISER BOULEVARD
Practice Address - Street 2:SUITE 200
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:484-509-0840
Practice Address - Fax:610-678-2100
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2020-02-06
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Provider Licenses
StateLicense IDTaxonomies
PAOS005307L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C34391Medicare UPIN