Individual
DR. EVAN MILLER MICHAELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2629 RIVA RD STE 114, ANNAPOLIS, MD 21401-7428
(410) 573-2530
(410) 573-2536
Mailing address
2629 RIVA RD STE 114, ANNAPOLIS, MD 21401-7428
(410) 573-2530
(410) 573-2536
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
D0101580
MD
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
D0101580
MD
Other
Enumeration date
04/06/2018
Last updated
03/31/2025
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