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Individual

JOHN C EVANOFF JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1990 COUNTRY RD U, METAMORA, OH 43540
(419) 644-4818
(419) 644-2589
Mailing address
1990 COUNTRY RD U, METAMORA, OH 43540
(419) 644-4818
(419) 644-2589

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35059829
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000141243
ANTHEM
OH
01
01-03360
UHC
OH
01
02035
PARAMOUNT
OH
01
0635152
AETNA
OH
05
0791586
OH
01
080120479
RRMC
OH
Enumeration date
07/18/2005
Last updated
11/03/2023
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