Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 44538 | MN |
NPI | 1326077611 |
---|---|
Provider Name | Dr. Maria Rae Evasovich |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455-0356 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2006 |
Last Update Date | 08/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
037928 | CONNETICARE (01) | CT |
046446 | HEALTHNET (01) | CT |
0557439 | (05) | IA |
080920900 | (05) | MN |
1031026 | PREFERRED ONE (01) | MN |
157405 | UCARE (01) | MN |
1646982 | ARAZ (01) | MN |
17-00026 | MEDICA PRIMARY (01) | MN |
17-00865 | MEDICA CHOICE (01) | MN |
2271271 | AETNA (01) | CT |
258A9EV | BCBS (01) | MN |
34301200 | (05) | WI |
G13121 | (02) | MN |
HP40310 | HEALTHPARTNERS (01) | MN |