Provider Demographics
NPI:1508029356
Name:EVANS, SAMUEL K (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:K
Last Name:EVANS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:170 DRAPER AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-3604
Mailing Address - Country:US
Mailing Address - Phone:508-699-6165
Mailing Address - Fax:508-342-1944
Practice Address - Street 1:170 DRAPER AVE
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-3604
Practice Address - Country:US
Practice Address - Phone:508-699-6165
Practice Address - Fax:508-342-1944
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA282310207RP1001X, 207RC0200X
RIMD13665207RP1001X, 207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine