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Individual
SAMANTHA ANN EVANKOVICH
Active
Individual
SAMANTHA ANN EVANKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000023A
IN
367H00000X
Anesthesiologist Assistant
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001260391
ANTHEM PTAN
IN
Enumeration date
07/25/2014
Last updated
12/03/2024
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