Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 40113 | SC |
N | 207P00000X | Emergency Physician | Q4998 | TX |
NPI | 1003250051 |
---|---|
Provider Name | Evan Daniel Kane |
First Address | Beaufort, SC 29902-5441 |
Second Address | Beaufort, SC 29902-5441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2013 |
Last Update Date | 30/01/2017 |