Evans, Michael Wynn

Evans, Michael Wynn is an individual health care provider with primary practice located at 384 Airport Rd , Hazle Township PA 18202-3325. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Evans, Michael Wynn can be contacted via phone (570) 501-1242.

Contact Information

Primary practice address
384 Airport Rd Hazle Township PA 18202-3325
Phone: (570) 501-1242
Fax: (570) 501-1252
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X MD439423 Pennsylvania

Profile Details

NPI number 1972782522
LBN Legal business name Evans, Michael Wynn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2007
Last updated Feb 13th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972782522 NPPES
Pennsylvania MEDICAID 102618108-0003
Pennsylvania MEDICAID PENDING

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