Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 9334329-1205 | UT |
NPI | 1629399001 |
---|---|
Provider Name | Mark Evan Stevens |
First Address | Saint George, UT 84770-3705 |
Second Address | Saint George, UT 84770-3705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2010 |
Last Update Date | 19/08/2021 |