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Individual
NATHANIEL R EVANS
Active
Individual
NATHANIEL R EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
39886
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39886
SOUTH CAROLINA LICENSE
SC
Enumeration date
06/16/2011
Last updated
07/28/2016
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