Individual
BRUCE A EVINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
44686
MN
207Q00000X
Family Medicine Physician
Primary
44686
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0117892
MEDICA
MN
01
—
058G7EV
BLUE SHIELD
MN
01
—
1040669
PREFERRED ONE
MN
01
—
169147D277
UCARE
MN
01
—
2083650
AMERICA'S PPO
MN
05
—
726436400
—
MN
01
—
A022
CHAMPUS
MN
01
—
HP41113
HEALTH PARTNERS
MN
Enumeration date
01/26/2006
Last updated
01/17/2014
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