Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 036-098507 | IL |
Y | 207RH0003X | Hematology & Oncology | 246238 | MA |
NPI | 1265468110 |
---|---|
Provider Name | Andrew M Evens |
First Address | Boston, MA 02111 |
Second Address | Boston, MA 02111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 05/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G94554 | (02) |