Provider Demographics
NPI:1649254889
Name:EVANS, DAVID B (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:850 WALNUT BOTTOM RD
Mailing Address - Street 2:STE 302
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3632
Mailing Address - Country:US
Mailing Address - Phone:717-258-5150
Mailing Address - Fax:717-258-3392
Practice Address - Street 1:850 WALNUT BOTTOM RD
Practice Address - Street 2:STE 302
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3632
Practice Address - Country:US
Practice Address - Phone:717-258-5150
Practice Address - Fax:717-258-3392
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009996E207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
01388901OtherBLUE CROSS
PA0006564200001Medicaid
018603OtherHIGMARK BLUE SHIELD
PA018603Medicare PIN
01388901OtherBLUE CROSS