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Individual
EVAN T. THEOHARIS
Active
Individual
EVAN T. THEOHARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME164423
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119330700
—
FL
05
—
316389710
—
MI
01
—
700H262210
BLUE CROSS-BLUE CROSS
—
01
—
ET057938
CHAMPUS-CHAMPUS
—
Enumeration date
11/29/2006
Last updated
10/06/2023
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