Provider Demographics
NPI:1811160468
Name:EVANS, CHRISTOPHER DRYDEN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DRYDEN
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 1:1906 PEABODY AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215-2821
Mailing Address - Country:US
Mailing Address - Phone:214-421-7848
Mailing Address - Fax:
Practice Address - Street 1:3181 SW SAM JACKSON PARK ROAD
Practice Address - Street 2:MAIL CODE L-475
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3098
Practice Address - Country:US
Practice Address - Phone:503-494-1198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMD9267207RI0200X
ORMD166842207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD166842OtherMEDICAL LICENSE
TXM9267OtherMEDICAL LICENSE