Evans, C. Douglas
Evans, C. Douglas is an sole proprietor health care provider with primary practice located at 669 Main St , Wakefield MA 01880-5200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Evans, C. Douglas can be contacted via phone (781) 245-5200.Contact Information
Primary practice address
669 Main St
Wakefield MA 01880-5200
Phone: (781) 245-5200
Fax: (781) 246-3932
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 77262 | Massachusetts |
Profile Details
| NPI number | 1982655643 |
|---|---|
| LBN Legal business name | Evans, C. Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 15th, 2006 |
| Last updated | Aug 8th, 2019 - about 5 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 | 1982655643 | NPPES |
| Massachusetts | MEDICAID | 3112870 |
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