Individual
MR. EVANS MICHAEL STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
280 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1838
(704) 237-4240
Mailing address
121A PROSPECT AVE, RALEIGH, NC 27603-2445
(919) 498-5181
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-10988
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
NC
Other
Enumeration date
06/15/2020
Last updated
02/24/2021
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