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Individual

MR. DAVID EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3533 SOUTHERN BLVD STE 2250, KETTERING, OH 45429-1270
(937) 534-0330
(937) 522-8995
Mailing address
3533 SOUTHERN BLVD STE 2250, KETTERING, OH 45429-1270
(937) 534-0330
(937) 522-8995

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50000431
OH
363AS0400X
Surgical Physician Assistant
Primary
50000431
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0088798
OH
Enumeration date
07/08/2005
Last updated
01/12/2021
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