Individual
STEPHANIE EVANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10020 DONALD S POWERS DR STE 2A, MUNSTER, IN 46321-4054
(219) 703-2427
(219) 703-6961
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01081251A
IN
207V00000X
Obstetrics & Gynecology Physician
62305
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102266823
ANTHEM
IN
05
—
300019320
—
IN
Enumeration date
04/13/2010
Last updated
12/16/2024
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