Individual
BRIAN RANDALL EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
309 W PINE ST, FLORENCE, SC 29501-4726
(843) 472-5255
(843) 472-5179
Mailing address
309 W PINE ST, FLORENCE, SC 29501-4726
(843) 669-5162
(843) 667-4573
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
33525
SC
208800000X
Urology Physician
ME96084
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01580077
RAILROAD MEDICARE
SC
05
—
Q014A
—
SC
Enumeration date
07/28/2006
Last updated
04/26/2018
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