Organization
FOUNDATION HEALTH CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B EVAN MD (PRESIDENT)
(330) 707-1425
Entity
Organization
Contact information
Practice address
6615 CLINGAN ROAD, SUITE A, POLAND, OH 44514
(330) 707-1425
(330) 757-2814
Mailing address
6615 CLINGAN ROAD, SUITE A, POLAND, OH 44514
(330) 707-1425
(330) 757-2814
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35-04-7881
OH
207Q00000X
Family Medicine Physician
Primary
35-049373
OH
207R00000X
Internal Medicine Physician
34-00-5052
OH
207R00000X
Internal Medicine Physician
35-08-6492
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073597472
NPI
—
01
—
1467436261
NPI
—
01
—
1588630404
NPI
—
01
—
1952385965
NPI
—
01
—
FO9371331
PTAN
OH
Enumeration date
05/09/2007
Last updated
02/11/2008
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