Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD013310E | PA |
NPI | 1003185851 |
---|---|
Provider Name | Dr. Charles Milton Evans |
First Address | Ephrata, PA 17522-8417 |
Second Address | Ephrata, PA 17522-8417 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2011 |
Last Update Date | 23/12/2011 |