Evankovich, Michael Richard
Evankovich, Michael Richard is an individual health care provider with primary practice located at 311 W 24Th St Suite 101, Erie PA 16502-2665. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Evankovich, Michael Richard can be contacted via phone (814) 452-4214.Contact Information
Primary practice address
311 W 24Th St Suite 101
Erie PA 16502-2665
Phone: (814) 452-4214
Fax: (814) 459-7823
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD060400L | Pennsylvania |
Profile Details
| NPI number | 1689621898 |
|---|---|
| LBN Legal business name | Evankovich, Michael Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Oct 1st, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689621898 | NPPES |
| New York | Other | 02079629 | NY MEDICAL ASSISTANCE |
| New York | Other | 182151 | NY MEDICAL ASSISTANCE |
| New York | Other | 212543 | NY MEDICAL ASSISTANCE |
| New York | Other | 261978 | NY MEDICAL ASSISTANCE |
| New York | Other | P00324768 | NY MEDICAL ASSISTANCE |
| New York | Other | 2662659 | NY MEDICAL ASSISTANCE |
| New York | Other | 1278964 | NY MEDICAL ASSISTANCE |
| New York | Other | 00025198402 | NY MEDICAL ASSISTANCE |
| New York | Other | 1041777 | NY MEDICAL ASSISTANCE |
| New York | MEDICAID | 0017973700003 | NY MEDICAL ASSISTANCE |
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