Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 350076073 | OH |
N | 208600000X | Surgeon | 350076073 | OH |
Y | 2086S0105X | Surgery of the Hand | 350076073 | OH |
NPI | 1235128547 |
---|---|
Provider Name | Stephen B Evans JR. |
First Address | Westlake, OH 44145-2399 |
Second Address | Westlake, OH 44145-2398 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2005 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2568403 | (05) | OH |
I33569 | (02) |