Individual
DR. EVAN MARIASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3435 W BROADWAY AVE, ROBBINSDALE, MN 55422-2969
(763) 581-2801
Mailing address
3435 W BROADWAY AVE, ROBBINSDALE, MN 55422-2969
(763) 581-2801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD13676
RI
207RH0003X
Hematology & Oncology Physician
Primary
59748
MN
208M00000X
Hospitalist Physician
LP00959
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002186601
MEDICARE
RI
01
—
1285850784
BCBS/BLUE CHIP
RI
05
—
EM85188
—
RI
Enumeration date
04/17/2007
Last updated
04/22/2021
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