Individual
EVAN CHARLES CUMPSTON
Active
Individual
EVAN CHARLES CUMPSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01087739A
IN
207YX0901X
Otology & Neurotology Physician
Primary
01087739A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001667242
ANTHEM PTAN
IN
05
—
300062370
—
IN
Enumeration date
03/23/2016
Last updated
04/11/2025
Update your record
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