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Individual

MARK W EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2101 EMBASSY DR, LANCASTER, PA 17603-2387
(717) 735-7410
(717) 735-7438
Mailing address
2101 EMBASSY DR, LANCASTER, PA 17603-2387
(717) 735-7410
(717) 735-7438

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
SC003096L
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC003096L
PA
213ES0131X
Foot Surgery Podiatrist
SC-003096L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02645500
CAPITAL BLUE CROSS
PA
05
1182516
PA
01
480006659
PALMETTO
PA
Enumeration date
04/26/2007
Last updated
09/29/2021
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