Provider Demographics
NPI:1356383368
Name:FRANK, EVAN DAVID (MD PHD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:DAVID
Last Name:FRANK
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-0245
Mailing Address - Country:US
Mailing Address - Phone:610-645-3472
Mailing Address - Fax:
Practice Address - Street 1:100 E LANCASTER AVE STE 459
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3434
Practice Address - Country:US
Practice Address - Phone:610-642-3800
Practice Address - Fax:610-642-4982
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07523400208VP0014X
PAMD040637E208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA515188Medicare PIN
PAE64179Medicare UPIN